Caring for children

Working paper - children living with and affected by HIV in residential care


In many countries, significant numbers of children are temporarily or permanently cared for in residential care. Evidence suggests that the phenomenon of residential care has been growing in recent years due to a complex interplay of different factors, among them HIV and AIDS. To date, there is no systematic information on the numbers of children living with or directly affected by HIV who are placed in residential care, the reasons for and the impacts of their placement on individual children, their families and communities and on the residential care facilities themselves.

This paucity of data makes it difficult to monitor the success of efforts to support family-based care, prevent separation and promote reunification for all children, including those affected by HIV. It also impairs efforts to ensure that children living with HIV in residential care are able to access HIV-specific services that are supportive and appropriate.

This is a working document which will be continually updated. If you have information and evidence to share, or questions on this report, please email:

The Guidelines for the Alternative Care of Children: A United Nations Framework

The Guidelines for the Alternative Care of Children were borne from a recognition of significant gaps in the implementation of the UNCRC for millions of children worldwide either without, or at risk of losing, parental care. The international community has therefore come together and developed these Guidelines for the Alternative Care of Children. They are the result of five years of discussions and negotiation between the UN Committee on the Rights of the Child, governments led by Brazil, UNICEF, experts and academics, representatives of non-governmental organisations and, last but not least, young people with care experience. Read more...

Family first: prioritising support to kinship carers, especially older carers

Family first: prioritising support to kinship carers

This paper demonstrates how recognising the value of kinship care, and addressing the challenges faced by children and carers, is likely to lead to a range of positive outcomes, including improved education and child protection, and better physical health and psychosocial well-being for older persons.

In some countries in sub-Saharan Africa, 90% of children who have lost one or both parents are looked after by relatives, in many countries, the effects of HIV & AIDS have left older relatives caring for children, and in countries such as Malawi, where large numbers of adults migrate for work, children are being cared for by their grandparents or other relatives.

Most of these arrangements are informal and therefore children and their carers may be missing out on social protection and benefits. Older carers may find it difficult to support children financially. While many kinship carers do their best, children, especially girls, may be exposed to discrimination and abuse.

The prevalence of kinship care means that this issue is not just of concern for those with a narrow alternative care or child protection remit, but also requires commitments from agencies working in health, social protection, justice and education to ensure that the needs of children in kinship care and their carers are met.

For more information on this initiative, please contact:

Intergenerational issues between older caregivers and children in the context of AIDS in eastern and southern Africa: ICASA 2011 presentation


Intergenerational issues between older caregivers and children in the context of AIDS in eastern and southern Africa: ICASA 2011.pps

Responding to regional recommendations to strengthen families as a unit of care within the context of children affected by HIV and AIDS, RIATT-ESA commissioned a study to better understand intergenerational issues for older carers and children orphaned by AIDS. This overview of the study was presented at ICASA 2011.

Namibia National Agenda for Children 2012-2016

Namibia's National Agenda for Children 2012-2016

The Namibia National Agenda for Children 2012-2016 is a call to action to put the constitutional mandate on the rights of children into implementable strategies. The Agenda is anchored on five pillars: health and nourishment; early childhood development and schooling; HIV prevention, treatment, care and support; adequate standard of living and legal identity; and protection against neglect and abuse.

The importance of Namibia developing its first-ever National Agenda for Children was highlighted through the publication of Children and Adolescents in Namibia 2010: A Situation Analysis, and through a review of the National Plan of Action for Orphans and Vulnerable Children (2006-2010). Two critical issues were identified through these processes: that Namibia needed to adopt a multi-sectoral approach to planning and implementation towards child-centred development, and that we needed to look more broadly at the concepts of vulnerability and inequity through the lens of a child’s life cycle.

Through a broad-based consultative process which involved government, NGOs, civil society organisations, children and development partners, the national commitments for children were identified, discussed and prioritised. While these five-year commitments have been integrated into current sector policies and plans to a large extent, the National Agenda for Children brings them together concisely, which will enable all stakeholders to plan, implement and monitor their actions for children in a coordinated manner. The Agenda also serves as a major contribution to overall national development planning processes.

While the Ministry of Gender Equality and Child Welfare has been assigned the task of facilitating the development of the national agenda for children, the primary responsibility for ensuring that is is implemented lies with the line ministries and their partners.

Enabling reform: Why supporting children with disabilities must be at the heart of successful child care reform

Enabling reform: Why supporting children with disabilities must be at the heart of successful child care reform

This research paper was developed jointly by the Better Care Network and EveryChild as part of the Better Care Network’s series of working papers on alternative care.

The paper argues that disability should be placed at the heart of child care reform due to the large number of children with disabilities living in harmful institutional care, the lack of support for families trying to care for children with disabilities, the lack of alternative care options for children with disabilities and legal and economic imperative to provide proper care for these children. It aims to inform those who are developing and implementing child care policies, and to demonstrate, through examples, how effective reform can be achieved.

The paper suggests that it is imperative for stakeholders working on both disability and alternative care to challenge discrimination and create the political will for reform, change national legislation and guidance on disability and alternative care to reflect the CRC, CRPD and Guidelines for the Alternative Care of Children, provide better support to families caring for children with disabilities and, as a matter of priority, end the institutional care of all children and ensure that children with disabilities have a range of high quality family-based alternative care options open to them.

The report is available here

Maternal Infant Young Child Nutrition - Family Planning (MIYCN-FP) Integration Toolkit

Maternal, Infant, and Young Child Nutrition-Family Planning (MIYCN-FP) Integration Working Group was established by the Maternal and Child Integrated Program (MCHIP) and its partners. This working group brings together the Postpartum Family Planning Community of Practice, the Lactational Amenorrhea Method (LAM) Working Group and the Nutrition community."

Women have understood the connection between breastfeeding and regulating their fertility for centuries. LAM integrates postpartum family planning and nutrition because it promotes exclusive breastfeeding which reduces malnutrition and mortality in infants in their first six months and extends birth intervals which, in turn, promotes maternal and child survival. K4Health has a toolkit for LAM under family planning methods.

FP-MIYCN messages and supportive programmatic activities continue beyond six months when mothers transition to other family planning methods and their infants are introduced to other foods (fruits, veggies, cereals and animal proteinwhile continuing to breastfeed.

For the healthiest babies couples need to space out the next pregnancy at least 24 months. Young children 6-23 months of age should be fed foods of adequate quality and quantity to complement the nutrients in breast milk. In countries where adolescent pregnancies are high, efforts to delay marriage and pregnancies before at least 18 years of age also should be part of  the entire family planning and nutrition program.

Online videos: Changing childcare in the region

REPSSI has just released two new short online online, looking at how care for vulnerable children can be improved at community level.

The first video, “Changing Child Care in Africa” (4 minutes in length) shows how graduates of a special new distance-learning course are applying what they have learned in communities across Africa. The Certificate Course in Community-Based Work with Children and Youth, developed by REPSSI and UNICEF, has changed how these community volunteers, social workers, teachers, police, community workers and community caregivers work with children. Hailed as an innovative solution to capacity-building, there are over 1000 students set to graduate this year from over 400 organisations in ten countries. Watch the video here.

The second video, “Voices from the community: Caring for our Vulnerable Children” (5 minutes in length) brings together voices of community members across Africa who feel empowered to do something to protect their vulnerable children. Teachers, village leaders, grandmothers and CBO staff explain the changes they and their communities have experienced thanks to training in psychosocial support, and demonstrate just how resourceful and dedicated ordinary people can be. Watch the video here.

Comprehensive sexuality education: The challenges and opportunities of scaling-up

Comprehensive sexuality education:the challenges and opportunities of scaling-up.pdf

This report builds on a programme of work on sexuality education for young people initiated in 2008 by UNESCO. The report emphasizes the challenges for scaling-up in terms of integrating comprehensive sexuality education into the formal curricula of schools.

Despite significant investment and programmatic interventions, levels of HIV prevention knowledge among young people have changed relatively little. This is particularly the case in countries that are most affected by HIV and AIDS. Comprehensive sexuality education is a long way from being institutionalized in most low- and middle-income countries where the HIV epidemic poses a disproportionate burden. Even in countries with the highest HIV rates, there are relatively few examples of scaled-up, sustainable programmes within educational curricula. Existing generations of schoolchildren are not receiving the information they need for their healthy development. Unless things change, future cohorts of children will be similarly disadvantaged.

The report is informed by several other past and ongoing initiatives related to scaling up sexuality education, as well as drawing on case studies presented at the Bogota international consultation on sexuality education, convened by UNFPA in 2010.


It emphasizes the challenges for scaling-up in terms of integrating comprehensive sexuality education into the formal curricula of schools. It aims to:


  • Provide conceptual and practical guidance on definitions and strategies of scaling-up, given the specificities of sexuality education.
  • Illustrate good practice and pathways for successful scale-up in light of diverse contextual parameters.
  • Provide some principles of scaling up sexuality education that are of relevance internationally.

Changing the face of care for vulnerable children: REPSSI Certificate Course in Community-Based Work with Children and Youth

Changing the face of care for vulnerable children: REPSSI certificate course in community-based work with children and youth.pdf

The Regional Psychosocial Support Initiative (REPSSI) reviews their Certificate Course in Community-Based Work with Children and Youth. It responds to a critical regional demand for quality training in child care, and specifically social and emotional (psychosocial) support, child protection and promotion of children’s rights. The Certificate is a standardised, accredited course for East and Southern Africa.

This overview provides information on the course and feedback on the impact it has had for those who have completed the course.

For more information about the certificate course, and how you can support students to enroll, contact: 

Willys Simfukwe, Head of Programmes,  or Lynette Mudekunye, REPSSI Deputy Executive Director,

REPSSI is also offering several training courses throughout the year on building capacity to provide psychosocial support and monitoring of support interventions. Find out more about these trainings on our events page.

Adopting better care: Improving adoption services around the world

Positive care choices series

This is the third working paper in EveryChild'€™s series of papers promoting positive care choices for children living without parental care by providing an evidence base on a range of care options and decision-making processes. It examines domestic and inter-€‘country adoption and aims to explore why adoption is so rarely used globally.

The paper also explores whether or not an expansion of adoption services could offer a potential solution to the millions of children around the world in need of permanent care and currently languishing in harmful institutions. It is based on a literature review and interviews with experts from around the world.

Policy recommendations from the research include: prioritising the prevention of loss of family care in the first place; developing clear policies and guidance on domestic and inter-country adoption; ensuring children in need of permanent care have adoption or other forms of permanent or long term alternative family-based care as an option; improve decision making on the balance between expediency and being thorough on adoption decisions; and development of a child welfare workforce and legal system to support these recommendations.

For more information on this initiative, please contact: . To post comments and join in the debate on the reform of child welfare systems, please visit the policy pages of our website

Abuja +12: Shaping the future of health in Africa,

A report launched today at the Special Summit of the African Union on HIV/AIDS, Tuberculosis and Malaria highlights increased, targeted health spending as an essential foundation to greater economic growth and development in Africa. The report, Abuja +12: Shaping the future of health in Africa, published by the African Union (AU) and the Joint United Nations Programme on HIV/AIDS (UNAIDS), reviews progress made since the AU’s 2001 Abuja Declaration—in which leaders pledged to mobilize domestic and international resources for health and remove barriers to the AIDS response—highlights remaining gaps, and prioritizes next steps.