Resource needs for the Protection, Care and Support of

Children Affected by AIDSStuart Kean, World Vision International

2a

Resource Needs for the Protection, Care and Support of Children Affected by AIDS

John Stover, Lori Bollinger: Futures Institute

Rachel Yates, Priscilla Idele: UNICEF

3

Purpose Purpose: Estimate the resources

required to achieve higher coverage of key actions for the protection of children affected by AIDS Update of 2005 estimates

Working group: UNICEF, Futures Institute, PEPFAR, World Vision, World Bank, Boston University

4

Key Changes From 2005 Estimates2005 Focus on NGO

material support to the child

Most resources needed for provision of food

2013 Mix of government

and NGO programs More focus on support

to households and communities

Cash transfers to households

Community savings schemes

Block grants Social care

5

Key components for calculating resource needs How do we define the population in

need? What types of support should be

included? How will the support be delivered? What are our coverage goals? What are the unit costs?

6

Defining Children in Need* Populations

Orphans HIV+ children

Vulnerable children**

Not living with either parent, or

Lost one or both parents, or

No educated adults in household

Economic Situation Living in

households that are below the poverty line

Living in households in the bottom two wealth quintiles

* Includes 121 low- and middle-income countries** UNICEF. Measuring the Determinants of Childhood Vulnerability, ICF/UNICEF, September 2012.

Defining Children in Need AIDS-Related: Orphans (children aged 0-17 who have

lost one or both parents to any cause) and children aged 0-14 living with HIV and Living in a household in the bottom two quintiles 68 million in 2013 and will decline to 52 million by

2020 Living in a household below the international poverty

line52 million in 2013 and will decline to 48 million by

2020 All Vulnerable Children: Children not living with

either parent, or who have lost one or both parents, or who are living in a household with adults with no education and living in a household ranked in the bottom two wealth quintiles

310 million in 2013 and will increase to 314 million by 2020

6

Population in need may decline

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 20200

10,000,000

20,000,000

30,000,000

40,000,000

50,000,000

60,000,000

70,000,000

80,000,000

ESARO WCARO MENA SAsia EAP CEE/CIS LAC

7

Decline is due to expansion of ART keeping parents alive, better PMTCT programs avoiding new HIV+ infections and economic growth reducing numbers in absolute poverty

Interventions Economic support

Direct material support Cash transfers to

families Village savings schemes HIV insurance

Education support Early childhood

development Block grants for

education Scholarships for primary

and secondary school Training for education

staff Out-of-school clubs

Community-based services

Social workers Community care workers Accountability

Administration and support

Governments NGOs Policy/legislation M&E

Not yet included Pediatric palliative care Prevention of gender-based

violence Alternative care (foster

homes, small group homes, etc.) 8

These interventions represent consensus between UNICEF and PEPFAR that can mitigate HIV consequences and support prevention and treatment efforts

Percent of Services Provided by NGOs

Cash Tr

ansfe

rs

Materia

l supp

ort

Village

savin

gs sch

emes

Early

childh

ood d

evelop

ment

Block g

rants f

or ed

ucatio

n

Schola

rships

for e

ducat

ion

Trainin

g/scho

ol club

s

Out-of-

schoo

l club

s

Socia

l work

ers

Commun

ity car

e work

ers

HIV insura

nce0%

10%20%30%40%50%60%70%80%90%

100%

2010 2020

9

Coverage Targets by 2020“Ambitious but Achievable” scenario

Material supportCash Transfers

Village savings schemesEarly childhood development

Block grants for educationScholarships for education

Training/school clubsOut-of-school clubs

Social workersCommunity care workers

HIV insurance

0% 10% 20% 30% 40% 50% 60%

CEE/CIS LAC Asia MENA SSA

10

Annual Unit Costs (2012 US$)Summary of 111 Reports

Intervention Average IQ Range PopulationMaterial support $60 ChildCash transfers $160 $200 - $700 HouseholdVillage savings schemes $52 $20 - $60 HouseholdEarly childhood dev. $71 $50 - $240 ChildBlock grants for education

$100 $90 - $340 6-17 yrs old

Scholarships $140 $75 - $310 6-17 yrs oldTraining/school clubs $35 $20 - $130 6-17 yrs oldOut-of-school clubs $12 $10 - $30 6-17 yrs oldSocial workers $4400 $3100 -

$19,000Worker

Community care workers $730 $520 - $3100 WorkerHIV insurance $3 $2 - $7 ChildAccountability $2 $1 - $9 Child

11Costs also include add-ons for administration (5%), policy/legislation (5%) and M&E (10%)

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Resource Needs by RegionOrphans and HIV+ children in poverty

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Millions

LAC

CEE/CIS

EAP

SAsia

MENA

WCARO

ESARO

13

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Millions

M&E

Policy/legislation

Administration: NGOs

Accountability

HIV insurance

Community care workers

Social workers

Out-of-school clubs

Training/school clubs

Scholarships

Block grants for education

Early childhood development

Village savings schemes

Material

Cash Transfers

Resource Needs by TypeOrphans and HIV+ children in poverty

Number of Children SupportedOrphans and HIV+ children in poverty

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 20200

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

Cash Transfers Material support Village savings schemesEarly childhood development Block grants for education

14

Limitations Some interventions not yet included due

to limited cost data Information on current coverage of

services is missing for some services

15

Conclusions A likely decline in numbers of

children in need offers opportunities to significantly increase coverage of key services

Increases in resources required to achieve target coverage are modest

Shifting mix of services means a greater role for government

16

18

Population in Need

Ambitious by Achievable

Coverage by 2020

One-third Increase in

Coverage by 2020

80% Coverage by 2020

Orphans and HIV+ children in poverty

$ 5.1 $ 3.3 $ 21

Orphans and HIV+ children in bottom two quintiles

$ 7.5 $ 5.3 $ 27

Vulnerable children*

$ 64 $ 48 $ 204

*Children not living with either parent, or who have lost one or both parents, or who are living in a household with adults with no education and living in a household ranked in the bottom two wealth quintiles

Estimated Resource Needs in 2020 by Definition of Population in Need & Coverage Scenarios (US$ billions)