A NEED TO INVEST IN WORKING INNOVATIONS IN SUPPORTING HIV POSITIVE CHILDREN IN SUB-SAHARAN AFRICA
Written by: Josiah Kiarie
IMPACT OF SOCIAL PROTECTION ON HIV CARE AND TREATMENT AMONG CHILDREN AND ADOLESCENTS: A NEED TO INVEST IN WORKING INNOVATIONS IN SUPPORTING HIV POSITIVE CHILDREN IN SUB-SAHARAN AFRICA.
HIV and AIDS has remained a global pandemic with social, economic and health effects. Globally, HIV prevalence is at 37.9M, with 1.7M being children (WHO/UNAIDS, 2018). In Kenya Persons Living with HIV (PLHIVs) are estimated to be 1.5M with 105,200 being children below 14years (NACC, 2018). According to WHO 2008, the global HIV epidemic control is not only by medical approaches, but also encompasses economic, social and political systems that have been put in place to help fight the scourge and manage its spread. UNAIDS 90-90-90 treatment targets have significantly provided a road map for ending HIV epidemic by ensuring maximum testing, complete linkage and treatment through Antiretroviral Therapy (ART), and viral suppression (VL) among people living with HIV.
While many existing social protection schemes were not set up with HIV as primary focus, their potential to contribute to a comprehensive HIV response has increasingly become noticeable and there is growing body of evidence demonstrating the positive impact of HIV related social protection. UNAIDS (2018) Business care on social protection highlights how HIV sensitive social protection can reduce vulnerability to HIV infections, improve and extend the lives of people living with HIV and support to individuals and households. The 2016 Political Declaration of HIV and AIDS encourages member states to strengthen national social and child protection systems to ensure that by 2020, 75% of people living with HIV, at risk or affected by HIV are benefiting from HIV sensitive social protection. As a result, social protection programs have been successful in developing countries with much efforts seen in fighting poverty and hunger. Countries and donor agencies across the world have adopted social protection strategies to complement and strengthen their efforts towards reducing poverty and vulnerability.
Studies such as Termin (2010) confirm positive impact of a variety of social protection instruments including cash transfers, food transfers, social health protection and fee exemption schemes on HIV and AIDS treatment. Termin indicates that social protection functions as an incentive to utilize services when delivered in the form of monetary payment associated with clinic attendance, testing or treatment adherence or mandatory condition or by releasing financial barriers to service utilization either through free or subsidized provision, health insurance or Cash Transfers (CT) which share the common effect in increasing affordability of service utilization. Pettifer et.al (2012) asserts that social protection through Cash Transfer has two thronged function both as incentive to behavior change and as income to relieve budget constraints to expenditure on the core foods and services required for a healthy life (food, basic healthcare and education).
While considering the above, a lot of emphasis and recognition in the recent past has thus been the call for social protection systems to respond to challenges that have been encountered by developing countries which include; food insecurity, chronic poverty and HIV pandemic among affected families. HIV and AIDS has continuously pushed households and people into poverty through labor incapacity with increased medical expenses. In addition, HIV related stigma and discrimination of marginalized persons living with HIV and households affected by virus has resulted into their exclusion from essential services.
In sub-Saharan Africa, countries such as Kenya have demonstrated commitment to supporting investment in social protection programming through budget commitments. The Kenya government has enacted a social protection policy to provide guidance to social protection programs including cash transfer, National Health Insurance Funds (NHIF), National Social Security Fund (NSSF) among other funds. Social protection has therefore been entrenched primarily through cash transfers program to improve household food security, education, access to basic health care, social support networks, and social health insurance fund and subsidy programs for orphans and vulnerable children (NGEC 2014).
Even though these interventions are available, many HIV positive children in Kenya are excluded from social protection because of the programs ineffective targeting, marginalization and stigmatization of HIV positive persons. HIV positive persons have reported that enrollment usually done by government officers is biased and characterized by favoritism, and nepotism and as a result ends up benefiting those who not do not really need assistance. Therefore, there is a need to deliberately target children living with HIV with existing social protection programs either from government or through donors in HIV programming. Such social programming should be widened above the conventional social protection approach of offering cash transfers, health insurance or food vouchers to also include “tailor made’’ livelihood solutions such as training in financial literacy and provision of assets to promote livelihoods. This will lead to sustainability of gains made through the ‘traditional’ social protection approaches as well as go a long way in ensuring that children overcome challenges of accessing HIV testing, care and treatment services.
Project Coordinator of a USAID funded community project for children living with HIV/AIDS project in Kenya
Email: firstname.lastname@example.org Skype: Josiah.kiarie