1. Early Childhood Development HIV/AIDS in Malawi
Presented by Malawi Country Team Dar-es-Salaam, Tanzania 2004

2. Situation of Malawi: Social Indicators
Pop – 10,800,000
65% of population lives below poverty level
Total number of children (0-18) 5,250,000
Ages 0-6 – 24.4% (2,777,000)
49% of children stunted

3. Social Indicators cont.
IMR – 104; MMR - 1,120; U5MR – 189 (main causes are malnutrition, anemia, pneumonia, diarrhea, malaria)
Urban – 25%; Rural 13% HIV+
1.2% children (0-14 yrs) infected with HIV (NAC 2003)
16-30% HIV prevalence in child bearing women

4. Situation of Orphans in Malawi
17.5% (937,000) of all children are orphans
24% of Orphans are under 5
49.9% are orphaned due to HIV/AIDS.

5. Situation of ECD Services
26% coverage of access to ECD services
Approximately 3000 CBCC’s (400 supported by UNICEF)
Ages 0-5 attend CBCC’s
40% of children at CBCC’s are Orphans
On average 100 Children registered at CBCC (1:50)
Less then 50% of caregivers are trained

6. Key Policies and Legal Framework
Human Rights Provision Ch. 4 Sect. 23
Children and Young Persons Act
Affiliation Act
Maintenance of Married Women Act
Wills and Inheritance Act
ECD, OVC, HIV/AIDS, Gender, People with Disabilities, Decentralization Policies
PRSP
National Health Plan: IMCI, PMTCT Policies

7. Programmes Targeting ECD and HIV/AIDS
Support to Orphans and families affected by HIV/AIDS
Community Child Care
(using the IECD approach)

8. Stakeholders
Ministry of Health, Gender, Agriculture, Water, Education, Finance, Local Government
NGO’s, CBO’s, FBO’s
UN Agencies
Bilateral Donors
Communities

9. Programme Objectives Support for orphans and families affected by HIV/AIDS
To ensure that families and orphans affected by HIV/AIDS are provided with appropriate care and support to facilitate healthy growth and development, education, protection, and participation
Strengthen the capacity of programme partners to collect and use information to monitor and evaluate programmes on early child care
Ensure that issues of orphans, ECD, and nutrition are well incorporated in relevant poverty reduction strategies

10. Programme Objectives Community Child Care
Provide family with skills to care for children including nutrition, health, and psychosocial support;
To ensure that acute malnutrition among under 5 children stays below 10%
Strengthen the capacity of implementing partners to collect and use information to monitor and evaluate programmes on early child care
To promote integrate childhood development during the 1st three years of life
To prevent death among children occurring in the homes

11. Programme Intervention Focus ECD/OVC
Advocacy on ECD/OVC
Support the capacity for parents/caregivers to provide early learning and stimulation, psychosocial development, and care for OVC
Establish CBCC’s and improve the quality of services to promote early learning and stimulation and the holistic development of children
Psychosocial support and counseling
Community Mobilization/Empowerment (Community Dialogue)
Support and training on IGA’s
Partnership and networking

12. Best Practices Multi-Sectoral Approach
Utilization of existing structures and local resources
Reaching the most vulnerable
Capacity building of parents/caregivers for providing quality care
Community Child Care initiatives (EL&S, Extended family care, granny’s and widows club, single mothers club )

13. Best Practices Community engagement (community dialogue)
CBCC as entry point for other development programmes
Human Rights Based Approach To Programming
Inclusion of Psycho-social support in the package of care
Maternal health and nutrition
Extended family care & Foster Care

14. Challenges Political Commitment not backed by adequate resources
High Level of Poverty; low literacy level
Increasing # of children affected by HIV/AIDS
Provision of Quality services
Capacity of service providers to provide integrated services
Service provider turnover rate
Inadequate human resources
Reaching children 0-8 (particularly 0-3)

15. Challenges Coordination/Convergence of Services
Appropriate infrastructures (physical)
Traditional Beliefs/Practices
Provision of EHP
Sector Wide Approach
Number of VCT’s within the communities
Child Participation
Advocacy to link knowledge/skills/practice
Communication strategies at community level

16. Gaps
Reliable data on the magnitude of the problem of children affected by HIV/AIDS, and Psycho-social development
Provision of quality integrated services with focus on ECD and HIV/AIDS
Implementation of operational guidelines for ECD
Resources (funding, materials, human)
Untrained Caregivers

17. Gaps Service Delivery for Children: Food and nutrition
Health (growth monitoring, referral)
Management of common complications associated with HIV/AIDS infected children
Parental Education and Support:
Parenting skills and knowledge
Counseling skills

18. Gaps Care Provider Training and Support
Standardized training and materials
Capacity of caregivers and trainers
Comprehensive care to care providers
Sensitization of the public on ECD
Inadequate advocacy on ECD and HIV/AIDS
Communication strategy not appropriate for behavioural change

19. Gaps Community Mobilization Follow up and sustainability
Community monitoring

20. Opportunities Availability of strong NGO’s, FBO’s, CBO’s
Availability of policies (e.g. ECD, OVC, PRSP)
Increase of father participation (trend improvement )
Emerging programmes (e.g. ARV therapy for infected children, ICHBC)
Increased demand from communities for ECD services
Community Monitoring tool for OVC
Ratification of CRC & CEDAW

21. Results/Evaluations
Identified trends in increase in child rearing practices
Follow up to baseline study underway
Review and development of ECD materials (syllabus, training manuals) underway
Rapid appraisal for OVC
ECD Mid Term Review
Launch of ECD & OVC Policy

22. Thank You From the Warm Heart of Africa