"To the other side of the mountain"
Towards An ECCD HIV/AIDS Action Plan for Ghana MOWAC, MMDE, MoEYS, GAC in Partnership with UNICEF, World Bank and POLICY Project Setting the Stage: Background Where we are, …. Actions to Date Began consultative process with various partners (MDAs, GAC, UNICEF, World Bank, POLICY Project) Drafted ECD HIV/AIDS background paper ECCD National Policy soon to be adopted OVC policy guidelines development in motion - process is also consultative and participatory Introduction/Background 1st AIDS case in 1986; 42 cases reported By Sept 2003, 72,200 AIDS cases HIV prevalence 2.6% in 1984; 3.4% in 2002 The Eastern region has a prevalence rate of 7.9%. Six of the twenty-four sentinel sites had prevalence rates above 5%. 2.9% of AIDS cases among children 0-9 yrs; 2.3% among 0-4 yrs UNDP assessment of AIDS orphans estimated 170,000 Country Profile The Status of Young Children BASIC INFORMATION AND SCOPE MEASURE OF THE PROBLEM Population 20.3m (2003 estimate) IMR 64 (GDHS 2003) U5MR 117 (GDHS 2003) Total number of children 10,474,000 Total number of Children 0-8 5,393710 (27.57% of total population) Not known. The Ghana AIDS Commission estimates that “there are about 169,754 AIDS orphans (all children aged below 18 Total number of children 0-8 affected by years) in Ghana.” The number of children 0-8 affected HIV/AIDS and infected by HIV/AIDS, is not known. Total number of children ages 0 to 6 3,709,000 Children ages 0 to 6 as percentage of total 17.7% population Enrolment in organized early learning 457,597 (public); 244,707 (Private) programme Formal preschool enrolment 44% (2002): Primary Level Gross Enrolment Rate 80%; boys 83%; Girls 76% Female Literacy 38% (2002) HIV Prevalence 3.4% (2002 sentinel median value) Number and percentage of OVCs 755,641.00* (and as a % of pop. aged 0-15 = 9.3%) Number and percent who are children orphaned 198,000.00 (26.2% of total orphans) by HIV/AIDS Number and percent of AIDS orphans under 4,263 (2005 estimate) five Projected total number of OVC by 2005 755,641.00 (2005) Projected total number of OVC by 2010 773,855.00 (2010) Leading cause of morbidity for young children Malaria, respiratory illness, diarrhoea mal-nutrition Leading cause of mortality for young children Malaria, acute respiratory illness dehydration diarrhoea Immunization coverage 69% of children 12-23 fully vaccinated Nutritional status All boys All girls Percent Stunted 26.5 23.7 Percent Wasted 6.6 8.4 Percent Underweight 23.8 22.7 Policies Constitution of Ghana Children’s Act 560 Draft ECCD Policy Draft National HIV/AIDS Policy National OVC Policy being developed GPRS Sectoral Policies (education, health, social welfare) Revised Population Policy 1994 Gaps Policies address children 0-18 yrs, except ECCD policy that targets children 0-8 yrs Information and programme needs for children 0-8 yrs impacted by HIV/AIDS Moving from Policy to Action Several low level community-based initiatives that need to be strengthened and sustained Capacities for coping with HIV/AIDS Most care (93%) is provided by Families 1/3 of orphans supported by female grand parents Communities, faith-based organizations, Traditional leaders and Institutions also provide some care Huge need among families, communities and institutions for more organized and sustained support systems Examples: Manya Krobo Queen Mothers, Widows Association in Obuasi etc Stigma associated with Young Children affected by HIV/AIDS Stigma still an issue due to low prevalence of epidemic However, targeted interventions do exist in high prevalence areas Specifically in targeted intervention areas stigma is minimum due to the type of care-giving arrangements in practice – community based support thru traditional leaders Access to Day Care and Pre-School Number of Day care centres – 2,876 Day-care enrolment 0-3 yrs - 231,624 Trained attendants – 4,836; untrained 5,697 Less than 20% of public pre-school teachers are trained Pre-school enrolment 44% 10,000 pre-schools Non-formal ECD Activities and Enrolment A lot, but unstructured Grandparents/Families support etc Intervention areas Delivery of services to young children integrated across sectors (encompass survival, protection and development; Egs. food, nutrition, education, shelter/institutional care, health/PMTCT) Education and Support for Families (Minimum counseling, minimum package of support thru NGOs, micro-financing, income generation etc) Training of care givers – area of great need (see Social Welfare indicators; also less than 20% of pre-school teachers are trained) Intervention areas -2 Sensitization and Mobilization initiatives at national, district and community levels using GARFunds and other resources - Key actors - CBOs, NGOs, FBOs and traditional leaders, MDAs etc - Targeted media events (eg. Cartoon animation, drama etc) Challenges Support to families since they provide a bulk of care and support activities Special information needs and sensitivity because of stigma Many barriers – infrastructure needs, scaling up successful interventions, eg Queen Mothers At local level, ADVOCACY for ownership Coordination of programmes Research to fill data gaps for ECD HIV/AIDS programming Opportunities Favourable policy environment (Draft policies on ECCD, OVC, National HIV/AIDS etc) Expansion in Pre-school Services Commitment of GoG, Traditional leaders GoG/UNICEF Indicators of Early Childhood Learning Standards Curriculum development for ECD that incorporates HIV/AIDS issues National Programme of Action for Children Several manual development initiatives including HIV/AIDS curriculum for Teacher Education Conclusion GoG commitment to process of addressing ECD and OVC made manifest by composition of team: - MOWAC and its agency GNCC - MMDE and its agency, Dept of Social Welfare - MoEYS and its agency, GES - GAC - GHS - other Partners (UNICEF, World Bank, POLICY Project, ECD Consultant) Team will be expected to draw up and follow through on Actions to be identified