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    Children orphaned by AIDS: a call for action for NGOs and donors.

    Poonawala S; Cantor R

    Washington, D.C., National Council for International Health [NCIH], 1991 Mar 31. [3], 27 p.

    AIDs provides a unique and unprecedented opportunity to affect behavioral change, open up discussion on sexuality, and strengthen health and educational programs. This National Council for International Health policy report encourages collaborative multisectoral programs to deal with the issues of AIDs orphaned children. The contents include introductory chapters as well as chapters on the economic, public health, and social implications of AIDs in the Third World; supporting the child, family,and community; recommendations for the role of NGO's and the role of donor agencies; and conclusions. It is hoped that NGOs and donors will be mobilized to deal with a problem that will strain the already inadequate health, social and financial resources of developing countries, and thereby affecting the increasing demand for long term child care. WHO estimates of HIV infected children <5 years are 10% of 25-30 million by the year 2000. The current problem also includes children orphaned from the estimated 3 million women who will die in 1990. The economic implications are that economic productivity is reduced, low income families will be unable to provide for the additional orphaned children, and debt and low prices for exports have already reduced national budgets and reflect less social spending. The public health implication is the 1-10 US dollars/per person health spending cannot accommodate AIDs screening which alone cost 1 US dollar. AZT costs 20,000 US dollars a year/per child, or the combined annual income of 133 Mozambique farmers. A child's AIDs hospitalization in Zaire costs 4 months wages for the average workers. A funeral costs 11 months wages. In Rwanda, the doctor/patient ratio is 1:36,000. Child survival may be reversed because of reduced credibility in breastfeeding and immunization, confidence in common health remedies, and of confusion between AIDs symptoms with other treatable ailments. AIDs confronts Africans with a challenge to their cultural beliefs and marital, family, and sexual patterns. The alternatives for care are the extended family, alternative residential facilities, and adoption and foster placement. It is recommended that NGO's increase information exchange/program coordination; balance short term emergency assistance with long term sustainable solutions; give priority to maintaining a child's sense of identity and ties with family, clan, and community; involve communities in all phases of project planning, implementation, and evaluation; provide resources to empower women to make choices; and ensure the discrimination due to HIV infection does not occur. Donor agencies should encourage NGOs to pursue multisectoral solutions; increase funding and improve dispursement means for NGOs; facilitate information exchange, funding, conducting research, offering strategic guidance, and taking responsibility for program coordination; ensure the sustainability of AIDs orphan's projects; and realize the goal of improved status of women and children legally, socially, and economically.
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