Human Development r 6 l SssONAL \ February 2002 Findings reports on ongoing operational, economic, and sector work carried out by the World Bank and its member governments in the Africa Region. It is published periodically by the WORLD BA N K Knowledge and Learning Center on behalf of the Region. The views expressed in Findings are those of the author/s and should not be attributed to the World Bank Group. Africa's Orphans and Vulnerable 'IVON AND Children 2 3 6 6 5 LI] IV/AIDS and violent conflicts of their vulnerability, examines the H are spawning a massive gen- prevailing community responses, eration of orphans in Sub-Sa- and argues the case for a concerted haran Africa. The region currently public action. The paper also re- has more than 12 million orphans views the ongoing interventions U ) who have lost either their mother and delineates some examples of or both parents, most of them un- good practices. der age 15. And the worst is yet to A come. Coping with the risks and Children at risk: causes and 3 X consequences of orphanhood poses consequences * immense problems for Sub-Sa- Pr haran Africa. Resources are lim- ThepossibilitythatanAfricanchild ited, communities are being over- will find himself or herself in diffi- whelmed, and the realization of cult circumstances is increasing m International Development Goals is rapidly as the number of risk situ- being threatened. Yet, the contours ations in the region grows. Even the if of public action are unclear be definition of at-risk children has cause of the limited knowledge of undergone a radical transforma- * the scale of the problem and a lack tion. The AIDS crisis, endemic war- tf of clarity on the effectiveness of in- fare, and frequent migrations have terventions. As a result, ongoing now changed the nature of risks interventions are piecemeal and faced by children and swelled the intervention arepiecninadequate, number of those at risk. Whatever While the impact of the epidemic the cause, orphans and other vul- is felt throughout communities and nerable children face the height- societies, the focus of the study, ened risk of malnutrition, mortal- Social Protection ofAfrica's Orphans ity, morbidity, and psychosocial and Other Vulnerable Children: Is- damage. The extent of a child's vul- nerability depends on a number of sues and Good Practice Program neaitydpdsoanubrf suesandGoodPraticeProram factors: whether they have been Options is limited to the analysis w of the implications of the growing infected themselves through child- of the implications of the gsrowing it rbesfeig hte numbers of orphans and other vul- b x nerable children for Africa's future they have relatives willing to care human development. It pulls to- for them, whether they are allowed gether the existing information on to go to school, how they are treated T A orphans and other vulnerable chil- within the community, what degree dren, traces the sources and extent of psychosocial trauma they have suffered from their parents death, what responsibilities they are left hold income may result in a wors- subsidies in particular would ben- with (i.e., younger siblings) and so ening diet and inadequate nutrition efit orphans for four reasons: a) forth. may impede their ability to learn. subsidies are easy to monitor and In both the short and long term, less prone to abuse or fraud than Magnitude of the problem many children will lose out on edu- other subsidies; b) education sub- cational opportunities that could sidies would give orphans the op- For the region as a whole, it is dif- make them more literate and more portunity to attend school when ficult to estimate the total number productive over their lifetime, lead- school fees are prohibitive; c) in the of orphans from all causes. Before ing to a host of externalities. In the short term, orphans would be bet- HIV/AIDS became widespread, ap- long-term, countries will suffer a ter integrated into local community proximately 2 percent of children reduction in productive human life; and d) in the long term, or- were orphaned; today the propor- capital resulting from a poorly edu- phans would have marketable tion has reached between 15-17 cation population. skills, making them more produc- percent in the most affected coun- tive members of society. Health and tries. Recent estimates place the Good practices nutrition subsidies can lengthen number of HIV/AIDS-orphaned the life expectancy of orphans, im- children (by far the largest group Assistance specially tailored for prove their learning achievement of orphans) at 12 million as of De- orphans can take several forms and while at school, enhance their pro- cember 1999. By the year 2010, include fostering, subsidies, trac- ductivity as they become adults, USAID estimates that there will be ing and reunification programs, and prevent increased health care 35 million. While HIV/AIDS or- and institutional care. costs and social protection later in phans are the largest group of vul- Fostering. Informal fostering life. However, health systems do not nerable children, they are not the within an extended family is usu- always function well in SSA and only vulnerable ones. To the list of ally the best intervention, provided supervising visits to clinics can be vulnerable children must be added that the care given is of an accept- more complex than supervising children orphaned from other dis- able level. Placing children with kin school attendance. eases and armed conflict, children promotes their integration into Family tracing and reunification. whose parents are sick and dying mainstream society, reduces their Finding close relatives of children of HIV/AIDS, child slaves, child risk of being marginalized and pro- orphaned by armed conflict re- soldiers, street children and those motes their psychosocial and intel- quires a program of tracing and children living in abject poverty. lectual development. Another ad- reunification: registering and enu- vantage is that family members are merating orphans and locating and Impact on families and most likely to act in the best inter- reuniting them with their family communities est of the child. Although this is not members. Tracing is sometimes Both the short and long-term eco- always the case, any intervention only the first step in protecting has drawbacks. And of all interven- vulnerable children. Typically, it is nomic and social costs on local and national economies and the soci- tions to date, most African govern- a one-off investment, provided that ety at large are important. In the ments, international donors, and relatives are found, that they are short term, households suffer from NGOs view fostering as the must willing to foster the child, and that culturally appropriate, sustainable they have the means to do so. anreductidbecome ill. Surviving and cost-effective approach. Institutional care. Orphanages infectedma becomhaveill Survig Education and health subsidies. have existed in Africa for decades adults may also have to reduce their labor time in agriculture or Subsidizing the education and and were originally run by mission- the informal or formal sector in health fees of orphans could be- aries. Today they are most likely to order to care for the ill or additional come the main means of promot- be found in post-conflict countries dependent children, resulting in a ing the placement of orphans with and are typically run by NGOs. The greater loss of income. Any loss of extended families. The chief merit high cost, sometimes questionable income may cause children to be of this intervention is that it sup- quality of care, and the reliance on pulled from school. Even if children ports investments in children with- orphanages as a refuge from pov- stay in school, the drop in house- out encouraging child labor. School erty have been the main arguments against them in developing coun- * There appears to be no single * Where orphans are numerous tries. Yet, given the swelling num- "best practice" option available to and community coping mecha- ber of orphans in SSA, it can be all countries in any environment. nisms have reached their limits, argued that some children will need Circumstances and needs of or- the case for wider institutional to be housed in orphanages, even phans and other vulnerable chil- interventions such as children's if on a temporary basis until per- dren vary widely between and villages appears strong. manent caregivers are found. Care within countries. . Orphanages are expensive and must be taken to adapt the con- * Fostering by relatives is more at- should be the last resort. When cept of orphanage to the socio-cul- tuned to the African sociocultural absolutely necessary, attention tural background of African soci- milieu than most other options should be paid to providing a eties. For example, a family-like en- and is also the option most preva- nurturing and stable environ- vironment for orphans can be pro- lent in most African countries. ment that avoids the potential vided by suitably adapting orphan- Fostering may also be the best stigma of an institutional up- ages into a children's village inside option in post-conflict countries. bringing. More evidence of cost- a community. Advantages to this However, the very conditions that effectiveness needs to be gathered approach are: a) they attract NGO make tracing and reunification before large institutional inter- support relatively easily; b) econo- necessary and attractive often ventions are planned for any mies of scale can be realized; c) make it difficult to realize desir- country. children's villages can call on the able outcomes. For example, rela- . Ongoing efforts are piecemeal support of the community in times tives, once located, may not be and inadequate for the magnitude of need; and d) children's villages capable of fostering in a war-torn of the problem. A coordinated re- can partner with faith-based economy. In any environment, sponse is critical for any response groups which would render the care needs to be taken that fos- to have a lasting and substantive approach more sustainable. tering does not lead to child impact. abuse. Conclusions * Wherever fostering is encour- aged, community or NGO over- * The numbers of orphans and sight may be necessary. While the other vulnerable children are al- extended family is still the most ready so large as to threaten the adequate social safety net, private traditional coping mechanisms, arrangements are not fail-safe. This article is based on the strengthening the case for pub- TO promote fostering both direct publication Social Protection of lic intervention. However, inter- subsidies (cash transfers) and Africa's Orphans and Vulner- ventions need to be carefully cho- subsidies (sh asfe d able Children: Issues and Good sen to: a) address the specific risks indirect subsidies (such as edu- Practice Program Options, faced by orphans in a given coun- cation vouchers and food supple- Africa Region Human Develop- try environment, and b) strengthen ments) have a role to play pedi- ment Working Paper Series, rather than supplant existing com- rect subsidies are largely prefer- August 2001, by K. Subbarao, A. munity coping strategies. able because they can be moni Mattimore, and K. Plangemann. tored easily to ensure that they For more information, please e- benefit the orphan. mail Amattimore@worldbank.org Fn dngs Findings can be accessed via the World Bank Group's website at http://www.worldbank.org/ Click on Publications, then Periodicals. Or, Findings would also be of interest to: click on Countries and Regions, then Africa Name Institution Letters, comments, and requests for publications not Address available at the World Bank Bookstore should be addressed to: Editor, Findings Operational Quality and Knowledge Services Africa Region, The World Bank 1818 H Street NW, Room J-5-055 Washington, D.C. 20433 e-mail: pmohan@worldbank.org