resource needs for the protection, care and support of children affected by aids stuart kean, world...
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Resource needs for the Protection, Care and Support of
Children Affected by AIDS
Stuart Kean, World Vision International
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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
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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
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Key Changes From 2005 Estimates
2005 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
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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?
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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.
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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
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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
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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
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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
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Percent of Services Provided by NGOs
Cash
Tran
sfer
s
Mat
erial s
uppo
rt
Village
savin
gs sc
hem
es
Early
childho
od d
evelop
men
t
Block
gra
nts f
or e
duca
tion
Scho
lars
hips
for e
duca
tion
Training
/scho
ol clubs
Out-o
f-sch
ool c
lubs
Socia
l wor
kers
Comm
unity
car
e wor
kers
HIV in
sura
nce
0%10%20%30%40%50%60%70%80%90%
100%
2010 2020
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Coverage Targets by 2020“Ambitious but Achievable” scenario
Material support
Cash Transfers
Village savings schemes
Early childhood development
Block grants for education
Scholarships for education
Training/school clubs
Out-of-school clubs
Social workers
Community care workers
HIV insurance
0% 10% 20% 30% 40% 50% 60%
CEE/CIS LAC Asia MENA SSA
10
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Annual Unit Costs (2012 US$)Summary of 111 Reports
Intervention Average IQ Range Population
Material support $60 Child
Cash transfers $160 $200 - $700 Household
Village savings schemes $52 $20 - $60 Household
Early childhood dev. $71 $50 - $240 Child
Block grants for education
$100 $90 - $340 6-17 yrs old
Scholarships $140 $75 - $310 6-17 yrs old
Training/school clubs $35 $20 - $130 6-17 yrs old
Out-of-school clubs $12 $10 - $30 6-17 yrs old
Social workers $4400 $3100 - $19,000
Worker
Community care workers $730 $520 - $3100 Worker
HIV insurance $3 $2 - $7 Child
Accountability $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
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$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
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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
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Limitations Some interventions not yet included due
to limited cost data Information on current coverage of
services is missing for some services
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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
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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)