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					         Response of
Community Social Safety Nets
   to the Needs of OVC
         in Lesotho




   World Food Programme - Lesotho

             December 2007
ii
FORWARD




I am pleased to present this report on “The Response of Community Social Safety Nets to

the Needs to OVCs in Lesotho”, based on the survey conducted by the World Food

Programme in 2007. In our efforts to respond to the increasing numbers of orphans and

vulnerable children, we believe it is important to understand more clearly the capacity of

social safety nets available at the community level, particularly during the drought

emergency period.

WFP interviewed 746 households across the drought affected Southern Lowlands and

Senqu valley region. It became clear that the growing needs of OVCs, as a result of the

impact of HIV & AIDS, have begun to overwhelm traditional forms of community social

safety net support, especially at the household level. This has particularly been the case

during the recent period of drought and chronic food insecurity.

As shown in the report, more investment is needed to develop sustainable agriculture,

broader asset bases and alternative sources of income, in order to increase the resilience of

households. In the long term, community support structures, with greater support from the

government and international community, are needed to play a more pivotal role in the

social support systems for orphans and vulnerable children.

I hope this study will be informative and of assistance to the many interventions working to

improve the livelihoods of orphans and vulnerable children in Lesotho.




Bhim Udas,
Representative and Country Director
World Food Programme.
Lesotho




                                             iii
iv
EXECUTIVE SUMMARY

Background

As a result of the impact of HIV & AIDS, Lesotho is struggling to respond to the needs of rising numbers of
Orphans and Vulnerable Children (OVC). Currently there are an estimated 118,000 orphans of which
approximately 82% have lost their parents due to HIV & AIDS. A number of safety nets have protected the
livelihoods of OVC through both formal and informal mechanisms. Traditionally, formal safety nets involved
the chief, village elders, church and Community Based Organisations (CBOs). In recent decades as Lesotho‟s
social welfare system has evolved, national safety nets have been established through a collaboration of the
Government, Non Governmental Organisations (NGOs), and international agencies. However these formal
safety nets have failed to respond effectively, in the face of rapidly rising numbers of OVC. Given the limited
financial and human resources available, these formal safety nets continue to be under-resourced, particularly
in the rural and mountainous regions where the terrain is particularly challenging.

As a result, informal safety nets through the extended family, kinship and community networks are being
increasingly relied upon to provide support where formal safety nets have failed to be effective. Historically,
Lesotho has had a strong tradition of extended family safety nets which took care of OVC. However recent
studies have indicated that households, as a result of taking on the extra burdens of caring for orphans, have
suffered from greater vulnerability and food insecurity. Extended family safety nets appear to be deteriorating
as a result of the loss of potential caregivers to AIDS, and the effects of reoccurring droughts, leading to
increased rural poverty.

Purpose

In order to understand more clearly the actual capacity of community social safety nets to respond to the needs
of OVC, this study was commissioned by WFP. This research has tried to ascertain whether, as a result of the
impact of HIV & AIDS, the capacity of external families & communities to support OVC are reaching a
threshold. To assess whether communities can continue to support OVC without suffering from significant
deterioration in their food security and livelihoods, particularly during emergencies such as widespread
drought, frequently experienced in Lesotho. In the process, findings from this study will be able to assist The
WFP, GoL, and other agencies to determine what interventions are needed to strengthen the capacity of
community based safety net‟s response to OVC.

Method

A quantitative survey was carried out, using a standardised questionnaire, of 746 households in the Southern
Lowlands and Senqu valley region (across the Mafeteng, Mohale‟s Hoek, Quthing and Qacha‟s Nek districts),
across rural and semi-urban areas. Half the households selected were those which supported orphans, while the
other half were not. Bivariate and multivariate analyses were carried out to examine the impact of supporting
orphans upon their livelihoods and thus determine whether households had the capacity to support orphans in
the future. Broader community level safety nets were examined using both quantitative and qualitative
information through focus group interviews with key stakeholders. Due to the design of the survey instruments
and difficulties encountered assessing the situation of vulnerable children, the study has focussed mainly on
safety nets for orphans.

Findings

The most important safety net for orphans has been the extended family, through which relative‟s households
have taken in and cared for orphaned children. The majority, three-quarters (75.7%) of these households were
headed by the elderly, widowed or chronically ill. These however, were the very households which have suffered


                                                       ii
from some of the highest levels of vulnerability and food insecurity, and thus have the least capacity to support
orphans. Whereas the very people with the socio-economic capacity to support orphans, including households
headed by men, married couples and those with regular salaried income, not suffering from chronic illness,
were less likely to be supporting orphans.

This survey found that households caring for orphans suffered from significantly higher levels of vulnerability
and food insecurity compared to those which did not. This indicated that the households surveyed do not have
the capacity to support orphans without it having a detrimental effect upon their livelihoods. However this
increased vulnerability was not only the result of caring for orphans, but also because the very households
which tended to support orphans were also more likely to be vulnerable and food insecure.

During emergency periods such as drought, all of the households surveyed clearly did not have the capacity to
support the needs of orphans. Households struggled with a lack of income earners to support themselves
through difficult times. Many were depending upon sources of income which would prove to be unreliable
during shocks and emergencies. Most households were lacking in the productive assets needed to provide
alternative sources of livelihood as a back-up to sustain themselves through a crisis. Given how households were
already resorting to detrimental coping strategies such as skipping meals, under normal circumstances, it was
clear that they would struggle to cope through periods of shocks and emergencies.

Beyond the extended family, wider community networks of friends and neighbours have been very active in
supporting households with orphans, mainly through food, clothing and financial assistance. Such informal
safety nets, which have succeeded in reaching far more OVC than official aid, suffered from being irregular and
unreliable during crises. In emergency situations the capacity of these safety nets was limited as the very people
in their community relied upon to provide support were themselves struggling to survive in similar situations,
with limited assets, and income stability to sustain themselves.

Traditionally in Lesotho, formal safety nets were provided through traditional institutions involving the chief,
elders, churches and other community based organisations. However these types of traditional safety nets were
found to be almost non-existent in the region. None of the households caring for orphans had ever received
assistance from local churches and only 2.3% have received assistance from community based organisations.

Therefore, outside the extended family, the main forms of safety nets relied upon to meet the needs of OVC were
the national systems of support implemented by the government, WFP, NGOs and other international agencies.

Conclusion

Community based safety nets clearly do not have the capacity to respond effectively to the needs of orphans
during emergencies. Most households do not have the capacity to support orphans in the future without it
having a detrimental effect upon their livelihoods. There is a need to not only target support to the most
vulnerable households (headed by the elderly, widowed and chronically ill) during emergencies, but also to
invest in strengthening their support for OVC outside emergency periods, through a larger asset base and
alternative sources of income in order to ensure more sustainable livelihoods. Significant investment would also
be needed to strengthen community safety nets in order for them to help fill the gap in the support of OVC in
rural areas where official safety nets struggle to be effective.




                                                          iii
ACKNOWLEDGEMENTS

WFP would especially like to thank the Department for International Development (DFID) for funding
this research paper.



WFP acknowledges the important role played by community leaders, chiefs, and councillors for contributions to
this survey. WFP would also like to also acknowledge the support from the following bodies, which were integral
to the success of this research.



District Secretaries and Administrations
        • District of Mafeteng
        • District of Mohale‟s Hoek
        • District of Qacha‟s Nek
        • District of Quthing


Government Departments and Agencies
           Ministry of Health and Social Welfare
           National AIDS Commission


Non-Government Agencies
           Lesotho Red Cross
           CARE Lesotho
           World Vision


UN Agencies
           UNAIDS
           UNICEF
           FAO (Mafeteng Project Office)
           WFP (ODJ – Southern Africa Regional Office)


Enumerators
        Thomello Ntsane, „Manapo Mohoanyane, Teboho Tohlang, Pheello Tsoikeli, Seisa Ramaisa


Consultants
        Motselisi Ramakoae, Moipone Mphahlela and Manana Mashologu for their work in planning the
        research and organising the data collection

        Clive Ashby for analysing the data and compiling the research report




                                                      iv
 TABLE OF CONTENTS


                                                                                                                                                     Page

EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                   ii

ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                      iv

TABLE OF CONTENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               v

LIST OF ACRONYMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             vii

GLOSSARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    viii

1.0 INTRODUCTION                                                                                                                                      1
             1.1        BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          1
            1.2         RATIONALE FOR THE STUDY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         5
            1.3         RESEARCH PROBLEM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 6
            1.4         OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      6
2.0 RESEARCH METHODS                                                                                                                                  7
             2.1       STUDY DESIGN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         7
             2.2       GEOGRAPHICAL AREA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  7
             2.3       SAMPLING STRATEGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                7
             2.4       DATA COLLECTION . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .             7
             2.5       DATA ANALYSIS . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .           9
             2.6       ETHICAL CONSIDERATIONS . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .                      9
             2.7       LIMITATIONS OF THE STUDY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                     9

3.0 FINDINGS                                                                                                                                          10
             3.1        HH SUPPORT FOR ORPHANS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        11

                          3.1.1        Forms of Household Support for Orphans . . . . . . . . . . . . . . . . . . . . . . . . .                       11
                          3.1.2        Characteristics of Orphans Supported by Households . . . . . . . . . . . . . . . .                             11
                          3.1.3        Characteristics of Households who Support Orphans . . . . . . . . . . . . . . . .                              12
                                       3.1.3.1      Gender of Household Head . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      12
                                       3.1.3.2      Marital Status of Household Head . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      13
                                       3.1.3.3      Age Group of Household Head . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .        14

                          3.1.4        Capacity of Households to Support Orphans . . . . . . . . . . . . . . . . . . . . . . .                        15
                                       3.1.4.1      Impact of Supporting Orphans upon Household vulnerability . . . . . . . .                         15
                                       3.1.4.2      Impact of Supporting Paternal, Maternal and Double
                                                    Orphans upon Household vulnerability . . . . . . . . . . . . . . . . . . . . . . . .              16
                                       3.1.4.3      Factors contributing to reduced capacity of Households . . . . . . . . . . . .                    17
                                       3.1.4.4      Households with the Least Capacity to Support Orphans . . . . . . . . . . .                       19
                                       3.1.4.5      Household’s Perception of their Capacity to Support Orphans . . . . . . .                         20

                          3.1.5        Household’s Capacity to Support Orphans in Emergencies . . . . . . . . . .                                     21




                                                                                 v
            3.2        INFORMAL SOCIAL SAFETY NETS FOR OVC. . . . . . . . . . . . . . . . . . . . . . . . . . .                                23

                        3.2.1        Characteristics of OVC support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        23
                        3.2.2        Capacity of Informal Safety Nets to support OVC in Emergencies . . . . . .                                24



            3.3        FORMAL SOCIAL SAFETY NETS FOR OVC. . . . . . . . . . . . . . . . . . . . . . . . . . . . .                              25

                        3.3.1        Traditional Community Safety Nets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             25
                        3.3.2        External Safety Nets involved in the Community . . . . . . . . . . . . . . . . . . . .                    25



4.0 CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       26


5.0 RECOMMENDATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                    28

            Appendix 1.              Sample Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   30
            Appendix 2.              Structured Interview Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      31
            Appendix 3.              HH Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    32



REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   41




                                                                            vi
ACRONYMS



  AIDS     -   Acquired Immune Deficiency Syndrome

  ART      -   Antiretroviral Therapy

  BOS      -   Bureau of Statistics

  CBO      -   Community Based Organisation

  CHS      -   Community and Household Surveillance

  CRS      -   Catholic Relief Services

  CSI      -   Coping Strategies Index.

  CWIQ     -   Core Welfare Indicator Questionnaire

  DMA      -   Disaster Management Authority.

  FCS      -   Food Consumption Score.

  GoL      -   Government of Lesotho

  HH       -   Household

  HIV      -   Human Immuno-Deficiency Virus

  IGA      -   Income Generation Activities

  MTCT     -   Mother to Child Transmission

  NAC      -   National AIDS Commission

  NGO      -   Non-governmental Organisation

  OVC      -   Orphans and Vulnerable Children

  PIH      -   Partners in Health

  PLHIV    -   People Living With HIV

  PMTCT    -   Prevention of Mother to Child Transmission

  STD      -   Sexually Transmitted Disease

  UNAIDS   -   Joint United Nations Programme on HIV & AIDS

  UNICEF   -   United Nations Children‟s Education Fund

  VCT      -   Voluntary Counselling and Testing

  WFP      -   World Food Programme.




                                          vii
GLOSSARY


Asset                     :   A resource having economic value that an individual or household owns or
                              controls with the expectation that it will provide future benefit.

Chronic Food Insecurity   :   A situation in which people and households are consistently unable to meet
                              their food consumption needs over time.

Chronic Illness           :   Any illness that renders an individual unable to engage in productive
                              activities for three months or more.

Community                 :   A mixed group that includes men, women and young people from all
                              subgroups within the locality.

Coping Strategies         :   Activities that people resort to in order to obtain food income and/or services
                              when their normal means of livelihood have been disrupted.

Coping Strategies Index   :   An index figure indicating the extent to which a person / household has
                              resorted to coping strategies.

Constituency              :   An electoral area.

Dependent                 :   A person who relies on another person for support (particularly financial
                              support).

Disability                :   A disadvantage or deficiency, especially a physical or mental impairment
                              which prevents or restricts normal achievement.

District                  :   A region of the country, used for administrative purposes.

Double Orphan             :   A child (under 18 years) who has lost both parents

Elderly                   :   A person 60 years or older.

Food Access               :   The household‟s ability to acquire adequate amounts of food through a
                              combination of their own home production and stocks, purchases, barter,
                              gifts, borrowing or food aid.

Food Insecurity           :   Food insecurity is the absence of food security.

Food Security             :   A situation in which all people at all times have physical, social, and
                              economic access to sufficient, safe and nutritious food which meets their
                              dietary requirements and food preferences for an active and healthy life.

Formal Safety Nets        :   Social support provided officially by institutions, organizations and the
                              government.

Household                 :   A social unit composed of individuals, with family or other social relations
                              among themselves, eating from the same source and sharing a common
                              resource base.




                                                   viii
Hunger                 :   A condition in which people lack the required nutrients (protein, energy,
                           vitamins and minerals) for fully productive, active and healthy lives. Hunger
                           can be a short-term phenomenon, or a longer-term chronic problem.

Income Earner          :   A person whose earnings are the source of support for the household and its
                           dependents

Informal Safety Nets   :   Social support provided on a private, unofficial basis by people in personal
                           contact with one another, e.g. extended family, friends, neighbours.

Livelihood             :   Combination of a household‟s capabilities, assets and activities required to
                           secure basic needs such as food, shelter, health, education and income.



Maternal Orphan        :   A child, under 18 years, whose mother has died. [In this study for the sake of
                           analysis, double orphans are not included as part of maternal orphans].

Orphan                 :   A child, under 18 years of age, whose mother, father or both parents have
                           died from any cause

Paternal Orphan        :   A child, under 18 years, whose father has died. [In this study for the sake of
                           analysis, double orphans are not included as part of paternal orphans].

Pitso                  :   A public gathering, usually convened by the chief.

Single Orphan          :   A child, under 18 years, who has lost one parent

Social Safety Nets     :   Provision of goods and services to protect the livelihoods of the most
                           vulnerable members of society especially from shocks and emergencies.

Stakeholder            :   An agency, organization, group or individual which has a direct interest in a
                           project, activity or its evaluation.

Vulnerability          :   The presence of factors that place people at risk of becoming food insecure or
                           malnourished, including factors which impede their ability to cope.
                           Vulnerability is a result of exposure to risk factors and underlying
                           socioeconomic processes that serve to reduce the capacity of populations to
                           cope with those risks.

Vulnerable Child       :   For the purpose of this study, a vulnerable child is defined as a child who is
                           living with a chronically ill adult member. In most cases this is their parent.




                                              ix
1.0      INTRODUCTION


1.1 Background

      HIV & AIDS in Lesotho

      Over the past decade, the Kingdom of Lesotho has faced the major challenge of responding to the needs of
      children orphaned and made vulnerable as a result of HIV & AIDS.

      According to recent figures, an estimated 23.2% of Basotho between the ages of 15 and 49 are living with
      HIV& AIDS. This accounts for approximately 235,000 adults, out of a total population of 1.8 million, with
      a further 26,260 adults newly infected each year (UNAIDS, 2005). As a result, the life expectancy has fallen
      dramatically within a decade from an average of 60 years to just 40 years (Kimaryo, et al, 2004). The HIV
      & AIDS epidemic in Lesotho has become a generalised epidemic, no longer within the confines of certain
      high risk groups. It has affected the entire population, across all sectors of income and education,
      geographically reaching even the remotest villages in the mountainous regions.


      Vulnerable Children

      Of those living with HIV, some 45,230 already have full-blown AIDS, many suffering from a multitude of
      infectious diseases, no longer able to work or support their children. Households, having lost their income
      earner are often forced to sell their productive assets, including livestock and agricultural land, in the
      process destroying their future sources of income. The recent DMA/WFP Targeting Exercise in the
      Southern Lowlands and Senqu river valley (DMA-WFP, 2006), found that 70% of households affected by
      chronic illness (in most cases HIV & AIDS) were particularly vulnerable to hunger and poverty.

      With a dramatic decline in household income and agricultural production, children are placed at greater
      risk of food insecurity and malnutrition. Often they are withdrawn from school as households are no longer
      able to cover costs of school registration, and the children themselves are needed to generate an income or
      stay at home to care for their parents (Kimaryo, et al, 2004). With no opportunities for education, these
      children‟s development and long-term prospects are greatly diminished. A study on the impact of HIV &
      AIDS on rural livelihoods and food security, showed that among households with People Living with HIV &
      AIDS (PLHIV), there were significantly higher numbers of children withdrawn from school (FAO,2005).
      Children living in this situation with a chronically ill parent are referred to in the study as „vulnerable
      children‟, usually made vulnerable as a result of the impact of HIV & AIDS. However, within Lesotho there
      is not a common agreed definition of vulnerable children and their situation. As a result, within this study,
      difficulties have been encountered in examining the needs and support for vulnerable children.
      Consequently, this research has mainly focussed on safety nets for orphans.


      Orphaned Children

      Over the last 20 years, approximately 168,680 people have died from AIDS in Lesotho. AIDS is now
      reported to be responsible for up to 50% of mortality in health centres across the country. This has led to a
      dramatic increase in the number of children orphaned. In 1996, the Lesotho Census data identified a total
      of 85,543 orphans; in 2003, the DMA-WFP orphan database registered 91,844 orphans and in 2004
      according to the RAAP survey (2004) there were an estimated 100,00 orphans.




                                                        1
Table 1.1 Fact Sheet : Lesotho (2004 – 2005)


Population & Health                                         Agriculture

Total Population                 1.88 million               Arable Land                       11 %

Children ( 0 - 18 )              857,000 ( 48% )            Popn. Involved in agriculture     86%

Median Age                       21.1 yrs                   Major Crops – Corn, Wheat, Sorghum, Barley

Birth Rate                       30.0 ( per 1,000 )

Death Rate                       12.8 ( per 1,000 )         Education

Population Growth Rate           2.0                        Adult Literacy Rate               81%

Fertility Rate                   3.5                        Primary enrolment : boys          81 %

No. Pregnant women                                          Primary enrolment : girls         86 %
per annum                        56,000

Maternal Mortality Rate          762 ( per 1,000 )
                                                            Orphans
Infant Mortality Rate            91 ( per 1,000 )
                                                            Total no. of Orphans (0-18 yrs)   180,000
Under 5 Mortality Rate           13 ( per 1,000 )
                                                            Total no. AIDS Orphans            100,000
Children <5 yrs Underweight      19.8 %
                                                            Orphans in Primary School         102,494 (57%)
Children <5 yrs Stunted          38.2 %
                                                            Orphans in Secondary School       22,575    (12.5%)
Children <5 yrs Wasted           4.3 %
                                                            Orphans out of School             54,931 (30%)
Ethnicity                        99% Basotho



Economy                                                     HIV & AIDS

GNP per Capita                   US$ 590                    Prevalence Rate (15 – 49 yrs)     23.2%

GDP per Capita                   US$ 635                    No. living with HIV & AIDS        265,000

GDP growth rate                  3.5 %                      No. adults with HIV & AIDS        233,000

Human Development Index          149                        No. women with HIV & AIDS         131,230

Industry contribution GDP        43.1 %                     No. children with HIV & AIDS      15,600

Agriculture contribution GDP 16.8 %                         No. people with AIDS

Services contribution GDP        40.9%                      Life expectancy   with HIV        35 yrs

% Population on                                             Life expectancy without HIV       65 yrs
Under $2 per day                 56 %

Unemployment Rate                45%
                                                            [ Min. Finance, GoL. , 2005 ]
Major Industries –      Textile, Food, Beverages,
                        Tourism, Construction               [ UNICEF, 2005a. ]

Major Exports      –    Water, Electricity, Textiles,
                        Labour, Agriculture




                                                        2
Currently there are an estimated 117,602 orphans in Lesotho, projected to rise up to 130,298 orphans in
2010 (Hunter, 1999). UNAIDS (2002) project this increase to be even more pronounced, with up to
206,000 orphans by 2010, accounting for 25.5% of all children under the age of 14 years (see table 1.2
below for a full list of estimates). While estimates vary, the cause is agreed to be primarily the impact of
HIV & AIDS, accounting for approximately 82.1% of children orphaned (UNAIDS, 2002).

For the purposes of this study an orphan is defined as a child under 18 years of age, whose mother, father
or both parents have died, from any cause. Orphans are referred to as either single orphans, who have lost
one parent, or double orphans who have lost both parents. A single orphan can be a maternal orphan in
cases where the mother has died, or a paternal orphan, in cases where the father has died.



          Table 1.2 Estimates of Orphan Numbers in Lesotho

           Year      Source                                                                       Est. No.

           1990      UNAIDS /UNICEF. 2002 . “Children on the Brink”                               73,000

           1995      UNAIDS /UNICEF. 2002 . “Children on the Brink”                               77,000

           1996      Lesotho Census (did not include children living in households)               85,543

           1997      US Census Bureau projections                                                 103,073

           2000      Hunter. 1999. Building systems of protection for children affected by        117,602
                     HIV/AIDS (UNICEF)

           2001      Ministry of Health & Social Welfare (Partial Survey of Orphans in Lesotho)   68,000

           2001      Gov. of Lesotho, Bureau of Statistics                                        68,000

           2001      UNICEF. “Africa‟s Orphaned Generations”                                      137,000
                     UNAIDS /UNICEF, 2002 . “Children on the Brink”

           2003      WFP – DMA joint registration.                                                91,844

           2003      Gov. of Lesotho, Bureau of Statistics.                                       92,000

           2004      UNAIDS. 2005. UNGASS Report                                                  100,000

           2004      RAAP survey                                                                  100,000

           2005      Hunter, 1999. “Building systems of protection for children                   126,510
                     affected by HIV/AIDS” (UNICEF)

           2005      U.S.A.I.D                                                                    180,000

           2005      UNAIDS /UNICEF. 2002. “Children on the Brink”                                193,000

           2006      Ministry of Education & Training                                             157,600
                     (Number of single & double orphans attending school)

           2010      UNAIDS /UNICEF. 2002. “Children on the Brink” (Projection)                   206,000

           2010      Hunter, 1999, “Building systems of protection for children affected by       130,298
                     HIV/AIDS”. (Projection)




                                                        3
Traditional Support Structures & Social Safety Nets

Historically, Lesotho has had a strong tradition of extended family safety nets which took care of orphaned
children and households facing shocks and emergencies (FAO, 2000). Safety nets are a component of social
protection with the aim of not only protecting but also promoting the livelihoods of society‟s most
vulnerable members (Greenblott, 2007). Safety Nets act as mechanisms that mitigate the effects of risks
such as illness and poverty, and emergencies such as conflict or drought.

A variety of safety nets address these risks, both formal and informal, as illustrated in figure 3.1 (page 10).
Formal safety nets refer to support provided officially by formal institutions, organisations and the
government. Within formal safety nets there are the more traditional forms of support at the community
level involving the role of the chief, the church and CBOs, and the more modern national based safety nets
involving Government, NGOs and international agencies. Informal safety nets refer to the support provided
on a private, unofficial basis by people in personal contact with one another, such as the extended family,
friends, and neighbours. Within this there are the familial safety nets and the wider community support
through friends, relatives and neighbours.



Formal Social Safety Nets & the Impact of AIDS

Over the last few decades as Lesotho has developed economically, various forms of support structures have
been established which have provided support to OVC in key areas. Primary Health Care has been
expanded across rural areas, so that for a nominal user fee of 10 to 15 maloti, even the most vulnerable
groups can have access to health care. In addition, networks of home base care workers have been
developed, as part of the Primary Health Care (PHC) model to support households affected by HIV & AIDS.
There is now universal access to primary education in Lesotho, which has enabled a far larger proportion of
OVC to have ongoing access to education (although the hidden costs of registration fees, transport and
uniforms still restrict access). In 2005/6, a National Policy and Action plan for Orphaned and Vulnerable
Children was established.

This has helped to incorporate support for OVC through the provision of food aid, covering additional costs
for school attendance, and the provision of psycho-social support through the work of social workers and
teachers. These safety nets have been developed through the collaboration of NGOs and international
agencies working in Lesotho, involving interventions such as the “Integrated Community home-based
Orphan Care Project” by Red Cross, and “Protecting and Improving Food and Nutrition Security of
Orphans and HIV/AIDS Affected Children” by FAO, WFP, and UNICEF.

The WFP in particular has been involved in providing a safety net to protect orphans from food insecurity
through its school feeding programme. Selected orphans, based on their levels of vulnerability, are given a
food ration to take home for their household at the end of every month. In the mountainous areas, the WFP
has been providing the food aid for school feeding in every primary school, in order to ensure that all
children, including OVC, receive a nutritious breakfast and lunch on a daily basis.

Despite these efforts, formal safety nets have failed to meet the full extent of OVC needs in Lesotho. Several
key factors have limited the capacity of formal social safety nets to effectively respond to the needs of OVC.

In the first place, formal safety nets suffer from being severely under-resourced, especially in the rural
mountainous areas where the terrain poses significant challenges to communication and transport
infrastructure. Lesotho, given its position as one of the poorest countries in the world, has struggled to
support the financial and human resources needed to implement effective safety nets.

A second factor has been the dramatic increase in numbers of OVC which have already started to
overwhelm existing safety nets. Furthermore, the impact of HIV & AIDS has resulted in deterioration of the


                                                  4
    capacity of government agencies to continue providing safety nets and social protection. As HIV & AIDS
    affects the most productive segment of the population, significant numbers of qualified teachers, nurses,
    health workers and social workers are being lost. In many cases their posts remain vacant or are being
    increasingly filled by inexperienced and unqualified staff.

    The culmination of these factors has severely overstretched the capacity of formal safety nets to respond to
    the needs of the rising numbers of OVC. As a result, informal safety nets in the community are being
    increasingly relied upon to fill these gaps in the provision of care and support services for OVC.


    Informal Social Safety Nets & the Impact of AIDS

    As mentioned earlier, traditionally these informal safety nets have proved to be an effective form of support
    for OVC, through the extended family, kinship and a community system of networks under the traditional
    authority of chiefs and elders (M.G. Makoae 2006). Recent studies, such as the one by RAAP (2004)
    however, suggest that both the familial and community structures can no longer absorb the rapidly
    increasing number of children orphaned. These very structures are starting to deteriorate as a result of (i)
    the loss of many adults in the community to AIDS, combined with (ii) the rising levels of chronic poverty
    and food insecurity in the rural areas, due to the 2002-2005 drought and declining employment
    opportunities.

    Consequently, the ability of households to absorb the rising number of OVC is rapidly reaching a threshold,
    beyond which there is a greater risk of drastic deterioration in their livelihoods. The Community Household
    Surveillance (CHS) results of 2005 (DMA-WFP, 2005) demonstrated that households caring for multiple
    OVC experienced a negative impact on food security and vulnerability to hunger. The more OVC being
    cared for by a household, the more severe the household‟s coping strategies became. In a survey
    undertaken by the DMA and WFP of vulnerable households in the Southern Lowlands and Senqu river
    valley (2006), nearly two-thirds of households hosting double orphans and half of those hosting single
    orphans were identified as being vulnerable to hunger and food insecurity.



1.2 Rationale for the study

    In order to understand more clearly the actual capacity of community social safety nets to respond to the
    needs of OVC, a study was commissioned by WFP. This research will be focussing, in particular on (i) how
    the capacity of community safety nets have been affected by the impact of HIV & AIDS in recent years, and
    (ii) the capacity of community safety nets during shocks and emergencies, such as widespread drought
    which has occurred frequently in recent decades.

    This study is needed in order to examine in further detail, initial findings from the CHS (DMA-WFP, 2005)
    and Senqu valley / Southern Lowlands report (DMA-WFP, 2005) on whether households can continue to
    support more OVC without suffering from greater levels of vulnerability and food insecurity. This study will
    help the WFP (and other agencies involved in supporting OVC such as the GoL, donors, and NGOs),
    understand to what extent safety nets in the community need to be supported and strengthened in order to
    help them respond more effectively to the needs of OVC. From this study agencies will be more aware of
    which aspects of the community based safety nets are struggling and thus need to be targeted for further
    assistance.




                                                       5
1.3 Research Question


    The overall research question investigates:

           -    To what extent can community social safety nets continue to support the needs of increasing
                numbers of OVC ?

    This can be divided into several specific questions, regarding:

        -       What types of social safety nets are active in the community?

        -       Are these social safety nets currently capable of supporting OVC?

        -       Do Households which support OVC struggle with significantly higher levels of vulnerability and
                food insecurity compared to those not supporting OVC?

       -        Do community safety nets have the capacity to support OVC through shocks and emergencies?

       -        In which areas do these community safety nets need strengthening?




1.4 Objectives
        1.     To identify the components of community based social safety nets for OVC.

        2.     To assess the capacity of community safety nets to continue supporting OVC

        3.     To examine the capacity of social safety nets to respond to the needs of OVC during emergencies

        4.     To recommend interventions in order to strengthen community based social safety nets in their
               support of OVC.




                                                      6
2.0 RESEARCH METHODS


2.1 Study Design
This study incorporated both qualitative and quantitative methodologies. Quantitative data was collected to
compare the levels of vulnerability and food insecurity depending on whether households were supporting orphans
or not, supporting single or double orphans, large or small numbers. The qualitative data was collected to examine
the impact of HIV/AIDS upon capacity of traditional community based social safety nets to cope with increasing
number of OVC. Due to limitations experienced in conducting qualitative interviews however, the majority of
findings are based upon the collection quantitative data through the use of questionnaires.



2.2 Geographical Area
This research seeks to expand upon the findings of the CHS (2006) and WFP-DMA report (2005) about
“Uncovering Chronic, Persistent Vulnerability to Hunger in the Southern Lowlands and Senqu River Valley”.
Therefore the study will focus within the WFP operational areas in the Senqu River Valley and Southern Lowlands
districts where persistent drought and poverty have led to decreased agricultural production and livelihood
opportunities and resulted in high rates of chronic vulnerability. Four districts (Mafeteng, Mohale‟s Hoek, Quthing,
and Qacha‟s Nek) were purposively selected using existing information from the Targeting Exercise regarding the
proportion of vulnerable HHs hosting Orphans.



2.3 Sampling Strategy
From these four districts, constituencies were selected to represent areas with both highest number of OVC (10
constituencies) and lowest numbers of OVC (4 constituencies), in order to assess how coping strategies change with
increasing numbers of OVC. This would also allow for comparison of available options in coping strategies and
social safety nets as the constituencies selected fall under the four livelihoods zones as shown in the map below.

From each constituency, a community council was selected to represent both rural and peri-urban areas and the
different proportions of OVC in communities and this yielded a total of 12 councils. From these community councils
a maximum of six (6) villages were selected in proportion to the size of the council to yield a total of forty eight (48)
villages. These villages were selected to represent both small and large communities and different levels of
accessibility to basic services such as clinics and main transport networks. The households surveyed were
distributed throughout the four livelihood zones as shown in the map below. The study‟s sample size of 746 was
chosen following the completion of the OVC census for each village, and was in proportion to the number of HHs
hosting OVC in each village. For comparison purposes, HHs selected in this study were divided between 50% (371)
who cared for orphans and 50% (375) who did not.


2.4 Data Collection

This survey was conducted with the support of community counsellors and the community members. Qualitative
data was collected through a structured interview (appendix 2) with a series of four focus groups (one per council)
involving community leaders, support group representatives, and village health workers. Quantitative data was
collected through the use of a standardised questionnaire (appendix 3) with the head of each household. The
questionnaire took approximately 20 to 25 minutes and was administered by the interviewer. 5 sections were
covered relating to the household demographics, income, expenditure, coping strategies, food consumption, food
assistance received, assets and livestock.




                                                         7
                    Fig. 2.1




                                 Fig. 2.2 Study Sample Area


                        Ñ
;   ;
                                                  Ñ
        Ñ

        Mafeteng
            ;
         ;;
        Ñ Ñ
                                                  Ñ
                                                              Ñ                                                                                                                  Ñ
                ;                                                                                                                                              Ñ
                                     ;                                                                                                                                                                 Ñ
                                     Ñ                                Ñ
                            ; ; ;
                                                                                                                                                                              Qacha's Nek
                                         Ñ                Ñ
                                                      Ñ                                                                   Ñ
                    Ñ                     ;                                                                                   Ñ
                                                                                                                                                                        Ñ
                                                                                               Ñ
                                                                                                                                              ;                                 Ñ
                                                                                                                                                         ; ;
                             ;                ;                                                                                                                    ;;
                                     ;;
                                 ;                Mohale's Hoek
                                              Ñ
                                                                                                                      Ñ
                                         Ñ
                                                                                       ;   Ñ   Ñ       ;;
                                                                                                                                  Constituencies
                                                                                                   Ñ
                                                                                                                                       Lebak eng
                                                                          Ñ                                                            Mafeteng
                                                                                                                                       Mohale's H oek                   ;    Vill age s
                                                                                                                                       Mount Moorosi
                                                                                                                                                                         Ñ   H eal th C e nter s
                                                                              Ñ
                                                                                  ;                                                    Moyeni
                                                                                                                                                                             M ain R o ads
                                                                                       ;                    Quthing                    Qac ha's N ek
                                                                                           ;                                           Qaqatu
                                                                                                                                                                             Sel ec ted c o unc il s
                                                                  ;                                           Ñ
                                                                                                                                       Qhalas i
                                                                                                                                       Tele                             Liv elihood Zones
                                                                                   ;                                                   Thaba-Phec hela
                                                                                  ;                                                                                            Foothill
                                                                                                                                       Thabana-M orena                         Mountain
                                                                                                                                       Tsoelik e                               Senqu River Valley
                                                                                                                                                                               Southern Lowland
                                                                                                                                       Districts Boundaries


                                                                                                                  8
2.5 Data Analysis

Quantitative data was analysed using SPSS and STATA software. Descriptive data is presented using frequency
tables, graphs and cross-tabulations. In order to determine HHs capacity to support orphans, levels of vulnerability
and food insecurity were compared between those which were supporting / not supporting orphans. Significant
differences were calculated using a confidence interval of 95%. Multivariate logistic regressions were carried out in
order to determine whether household‟s which suffered from increased vulnerability and food insecurity, were due
to the support of orphans or other pre-existing socio-economic factors.


2.6 Ethical Considerations

At the beginning of each interview the respondent was informed about to the purpose of this research and nature of
the interview. Each participant was asked for their consent to participate in the interview. Participants were
assured that their confidentiality would be protected, and advised of their right to refuse to participate or answer
any question, without any repercussions.


2.7 Limitations of the Study

The following limitations were observed:

        Timing: The timing of this study coincided with the election period. In some areas, councillors were not
         available and the Chief could not confirm the requested lists of OVC on their own (Mohale‟s Hoek,
         Majakaneng). This to some extent hindered progress of data collection.

        Language: In some parts of the sampled areas there were language barriers, in terms of Xhosa and Phuthi
         used in the vernacular (some parts of Quthing and Qacha‟s Nek).

        Village boundaries: Some villages were not easily accessible. Time spent travelling to and from those
         places was more than two hours in some areas.

        Under record of Child headed HHs: Most villages did not record child headed HHs because there are some
         relatives that are responsible for these children though they are not living in the same house.

        Most of the sample was strategically selected, rather than randomly selected. Therefore statistically
         conclusions cannot be derived which accurately represent the whole region.

        Within the questionnaire design there was no scoring system for vulnerability and asset levels, which
         prevented direct comparisons being made between groups in this area.




                                                        9
3.0 FINDINGS


In chapter three, the findings are presented from the analysis in to the capacity of social safety nets to respond
to the needs of OVC. A number of different community based social safety nets were examined, both formal
and informal (fig.3.1). Of these, it was the households who take in orphans through the extended family, which
were a key focus of community social nets and will be examined in section 3.1. In section 3.2, the capacity of
other informal safety nets will be examined, including friends, relatives and neighbours. Section 3.3 will
examine the capacity of formal support structures in the community, involving the more traditional (chief,
village elders & church, CBOs), and more modern (NGOs, local government) forms of support.


In line with the objectives of this research, each of these areas of OVC support will be examined, in order to
understand:
   a)   the forms of support they provide for OVC
   b)   their capacity to respond to the needs of OVC in the future
   c)   their capacity to support OVC during periods of shocks and emergencies
   d)   the impact of HIV & AIDS on these safety nets




                             Fig. 3.1 Community Social Safety Nets & Support Structures




                                                                             FORMAL               N.G.O.
                             INFORMAL                                                             s


                                          Neighbours                       C.B.O
                                                                           s                    Local
                                                                                                Governmen
                         HHs                                                                    t
                                                                              Chief
                                             Relatives
                                                                              & Elders                Church
                          Friends




Originally the study planned to examine social safety nets both orphans and vulnerable children. However in
Lesotho there is no common agreement as to the definition of a vulnerable child and so it has been difficult to
arrive at an effective measurement of their situation. This survey focussed on the definition of vulnerable
children as those from HHs where one of the members (usually their parent) was chronically ill. However the
questionnaire used did not assess whether HHs had taken in and supported vulnerable children, it only
inquired as to whether their own children were made vulnerable by the chronic illness of an adult in the HH.
Due to the different types of measurements involved, orphans and vulnerable children will be analysed
separately in the following pages.




                                                      10
3.1 Household Support for Orphans


3.1.1 Forms of Household Support for Orphans
In the vast majority of cases, HHs from the extended family have taken in orphans following the death of either
one or both parents. Orphan care and support by HHs in the extended family involved the provision of the basic
essentials of food, clothing and shelter. In Lesotho, while the costs of education and health are minimal,
additional registration fees for primary school and user fees for health care, were generally covered by the HHs
caring for orphans. However it was difficult to determine the extent and characteristics of HH support further
given that only a limited amount of information on this issue was collected during the interviews.


3.1.2 Characteristics of Orphans Supported by Households
For comparison purposes, HHs selected in this study were divided between 50% (371) who cared for orphans
and 50% (375) who did not. The number of orphans taken in by HHs ranged from one up to six children, though
the mean was just under two (1.9). Of the HHs caring for orphans, almost half, 46%, supported just one orphan,
28% supported two orphans, 17% supported 3 orphans, 6% had 4 orphans, and 3% had 5 to 6 orphans. As can
be seen from figure 3.2 below, most HHs supported one to two orphans.

The majority of HHs with orphans supported single orphans (64%). A large proportion of these HHs, 41% were
supporting paternal orphans while a quarter of HHs, 25% were caring for maternal orphans. As many as 44% of
HHs cared for double orphans. In Basotho culture double orphans have traditionally being identified as „true‟
orphans‟, having no remaining biological parent and so in the greatest need of support. Out of the total sample,
246 double orphans were cared for by 162 HHs; 319 parental orphans supported by 153 HHs; and 151 maternal
orphans, cared for by 91 HHs. Given that HHs may at times be supporting both double and single orphans there
is a degree of overlap in the percentages calculated.

Vulnerable children were defined as children living with a chronically ill adult member in the HH. 16% of HHs
had chronically ill adults whose children as a result were made vulnerable. Some of these HHs supported both
orphans and vulnerable children, so there was some degree of overlap. However, whereas HHs with orphans
had taken them in to support them, vulnerable children were already part of the HHs they grew up in and so
had not been taken in by other HHs.


                                                                  Fig. 3.2 Distribution of HHs
                                                                  Distribution of Households Supporting Orphans
                                                                             Supporting Orphans



                                                                 1 orphan
                                                                 46% H/H                                     2 orphans
                                                                                                             28% H/H




                                                                                                         3 orphans
                                                                                                         17% H/H


                                                                                                 4 orphans
                                                                                  5 -6 orphans
                                                                                                 6% H/H
                                                                                  3% H/H




                                                        11
 3.1.3       Characteristics of Households who support Orphans


 3.1.3.1      Gender of Household Head
 It is important to note that the vast majority of households supporting orphans, 70.6%, were female headed;
 only 29.4% were male headed. In fact, out of the all the female households surveyed, 61.8%, supported orphans,
 compared to only 33.9% of all male headed HHs (table 3.1). The gender of household heads was significantly
 associated with whether or not they cared for orphans (Likelihood Ratio chi-square test X2(1) = 57.987,
 p<0.001), with female headed HHs 3.16 times more likely to support orphans than male headed HHs.

 Female headed HHs also tended to support larger numbers of orphans. 29.4% of female headed HHs supported
 three or more orphans compared to only 16.5% of male headed HHs. Female headed HHs were 2.1 times more
 likely to support three or more orphans compared to male headed HHs (Likelihood Ratio chi-square test X2(1) =
 7.105, p<0.05).

 In terms of single orphans, male headed HHs were significantly more likely to support maternal orphans
 (Pearson chi-square test X2(1) = 34.786, p<0.001), whereas female headed HHs were significantly more likely
 to support paternal orphans (Pearson chi-square test X2(1) = 51.358, p<0.001). 53.1% of female headed HHs
 supported paternal orphans compared to only 12.8% of male headed HHs. With maternal orphans, only 16.0%
 of female headed HHs supported orphans compared to 45.0% of male headed HHs. For double orphans, no
 significant difference was found between the number of orphans cared for by male and female headed HHs.




                                                   Fig. 3.3 Gender of Heads of HHs                   Male
                                                            supporting Orphans                       Headed
                                                                                                     29.4%




                                                                                  Female
                                                                                  Headed
                                                                                  70.6%




Table 3.1 Association between Type of Orphans Supported and Gender of the HH head.

                                Female           Male        Odds Ratio                Chi-Sq
 Outcomes                                                                     P
                              Head of HH      Head of HH    (Female Head)               Test

 Support Orphans    Yes      262 (61.8%)      109 (33.9%)        3.16       < 0.001   Likelihood
                    No       162 (38.2%)      213 (66.1%)          -                    Ratio
                    Total    424 (100%)       322 (100%)

 No. of Orphans     Yes      77 (29.4%)       18 (16.5%)         2.10       < 0.05    Likelihood
                    No       185 (70.6%)      91 (83.5%)           -                    Ratio
                    Total    262 (100%)       109 (100%)

 Support Paternal   Yes      139 (53.1%)      14 (12.8%)         7.67       < 0.001    Pearson
 Orphans            No       123 (46.9%)      95 (87.2%)           -
                    Total    262 (100%)       109 (100%)

 Support Maternal   Yes      42 (16.0%)       49 (45.0%)         0.23       < 0.001    Pearson
                    500
                    No       220 (84.0%)      60 (55.0%)           -
 Orphans
                    Total    262 (100%)       109 (100%)

 Support Double     Yes      108 (41.2%)      54 (49.5%)         N/A        0.142     Likelihood
 Orphans            No       154 (58.8%)      55 (50.5%)          -                     Ratio
                    Total    262 (100%)       109 (100%)




                                                            12
3.1.3.2     Marital Status of HH Head
There was a marked difference in the marital status of most male and female headed HHs caring for orphans, as
shown in figure 3.4. Whereas most male headed HHs were married (74.2%), the majority of female heads were
widowed (62.5%).

A large percentage of HHs caring for orphans were headed by widows (61.7%), mostly widowed women. Only a
minority of orphans were supported by HHs which were headed by married couples (19.9%).

As can be seen from table 3.2, whereas the majority of widow headed HHs (76.1%) had chosen to take care of
orphans, the majority of married couples (25.5%) did not, despite in most cases having far greater capacity and
resources. HHs headed by widows were significantly more likely to support orphans than HHs headed by
married couples, by a factor of as much as 9.28 times (Pearson chi-square test X2(1) = 151.138, p<0.001).

Widowed heads of HHs were also significantly more likely to support larger numbers of orphans compared to
married couples (Likelihood Ratio chi-square test X2(1) = 9.656, p=0.002). HHs headed by widows were 2.88
times more likely to support 3 or more orphans than HHs headed by married couples.



The majority of single and double orphans were supported by HHs headed by widows. Although in the case of
double orphans, married heads of HHs showed a greater willingness to be involved in their care. Married heads
of HHs were 4.4 times more likely to be involved in supporting orphans than widowed heads of HHs
(Likelihood Ratio chi-square test X2(1) = 22.389, p<0.001).

Fig. 3.4
                                       Fig. 2.2 Marital Status of Head of Household
Marital Status of
Heads of HHs
                                      Male                                      Female
according to Gender
                            11.18%                                                        12.03%


                    7.14%
                                                                                                                          married
                                                                                                     12.74%               partner, not married
                7.45%                                                                                                     divorced/separated
                                                                                                                          widow/widower

                                                                62.50%                               12.74%


                                                     74.22%




                                                               Married       Widowed       Odds Ratio
                               Outcomes                                                                         P       Chi-Sq Test
                                                              Head of HH    Head of HH    (Widowed Head)
Table 3.2
                               Support Orphans    Yes         74 (25.5%)    229 (76.1%)       9.28            < 0.001     Pearson
Association between
                                                  No          216 (74.5%)   72 (23.9%)          -
the Type of Orphans                               Total       290 (100%)    301 (100%)
Supported and Marital
                               No. of Orphans     Yes         10 (13.5%)    71 (31.0%)        2.88            0.002     Likelihood
Status of the HH head.                            No          64 (86.5%)    158 (69.0%)         -                         Ratio
                                                  Total       74 (100%)     229 (100%)

                               Support Paternal   Yes         11 (14.9%)    123 (53.7%)       6.65            < 0.001     Pearson
                               Orphans            No          63 (85.1%)    106 (46.3%)         -
                                                  Total       74 (100%)     229 (100%)

                               Support Maternal   Yes         22 (29.7%)     56 (24.5%)       N/A             0.372        N/A
                                                  500
                                                  No          52 (70.3%)    173 (75.5%)        -
                               Orphans
                                                  Total       74 (100%)     229 (100%)

                               Support Double     Yes         47 (63.5%)    74 (32.3%)        0.23            < 0.001   Likelihood
                               Orphans            No          27 (36.5%)    155 (67.7%)         -                         Ratio
                                                  Total       74 (100%)     229 (100%)




                                                               13
3.1.3.3      Age Group of HH Head
In terms of age, three groups of households supported orphans, those headed by children (under 18 years),
adults (18 – 59 years), and the elderly (60 years and over). Currently, only a minority of HHs in Lesotho are
headed by children, in this survey only 6 of the 428 HHs sampled. However these statistics fail to highlight
numerous situations where children are in effect the heads of HHs, where adults are mostly working away from
home, or are chronically ill, supported by children who have taken on the role of caregiver.

Most orphans are being taken care of by relatives and the extended family, in HHs headed by adults (63.9%).
However a considerable proportion of HHs, 34.5% were also headed by the elderly, who as demonstrated in the
next section, are far more likely to be vulnerable and food insecure, particularly during shocks and emergencies.

The elderly especially played an important role in support of double
                                                                                      Fig. .3.5 Age groups of Heads of HHs
orphans. 42.6% of HHs supporting double orphans were headed by                                    supporting Orphans
the elderly compared to 28.2% of HH without orphans. Elderly
headed HHs were significantly more likely to support double
                                                                                                                        Elderly Head
orphans, than adult headed HHs, by a factor of 1.98 times                                                               34. 5%

(Likelihood Ratio chi-square test X2(1) = 9.511, p=0.002).




                                                                                                                        Child Head
                                                                                                                        1. 6%
                                                                                       Adult Head
                                                                                       63. 9%




      Table 3.3 Association between Type of Orphans Supported and Age of the HH head.

                                        Adult           Elderly       Odds Ratio
          Outcomes                                                                          P       Chi-Sq Test
                                      Head of HH       Head of HH    (Elderly Head)


          Support Orphans    Yes      237 (47.1%)     128 (54.0%)         N/A              0.08     Likelihood
                             No       266 (52.9%)     109 (46.0%)          -                          Ratio
                             Total    503 (100%)      301 (100%)

          No. of Orphans     Over 2    61 (25.7%)      30 (23.4%)         N/A             0.627     Likelihood
                             1-2      176 (74.3%)      98 (76.6%)          -                          Ratio
                             Total    237 (100%)      128 (100%)

          Support Paternal   Yes      114 (48.1%)      38 (29.7%)         0.46             0.01     Likelihood
          Orphans            No       123 (51.9%)      90 (70.3%)           -                         Ratio
                             Total    237 (100%)      128 (100%)

          Support Maternal   Yes       54 (22.8%)      36 (28.1%)         N/A             0.262     Likelihood
                             500
                             No       183 (77.2%)      92 (71.9%)          -                          Ratio
          Orphans
                             km &
                             Total    237 (100%)      128 (100%)
                             over
          Support Double     Yes      88 (37.1%)       69 (53.9%)         1.98            0.002     Likelihood
          Orphans            No       149 (62.9%)      59 (46.1%)           -                         Ratio
                             Total    237 (100%)      128 (100%)




                                                        14
3.1.4 Capacity of HHs to Support Orphans
In this section the capacity of HHs to respond to orphans‟ needs will be assessed, under normal conditions.
Following this the study will then assess the capacity of HHs in the context of shocks and emergencies and as a
result of the impact of HIV & AIDS.

The future capacity of HHs to care for orphans is based upon the current food security and socio-economic
status of HHs which have been caring for orphans. Recent CHS results (2005) and the Senqu river valley study
(2006) demonstrated that HHs caring for multiple OVC experienced higher levels of food insecurity and
vulnerability to hunger. If HH‟s livelihoods become vulnerable and food insecure as result of supporting OVC
then there is clearly no more capacity for HHs in the community to support more orphans in the future. On the
other hand if HHs caring for Orphans experience little or no impact on their livelihoods, then there is further
capacity for HHs to support OVC in the future. Several key indicators were used to assess whether HHs
supporting orphans suffered significant loss of livelihoods:

                       Overall Percentage of non-income earners in the HH

                       Proportion of non-income earners for every income earner in the HH

                       Food Consumption Levels

                       Dependency upon food aid or food gifts

                       Extent to which HHs have resorted to coping strategies (Coping Strategy Index)


3.1.4.1 Impact of Supporting Orphans upon HH vulnerability
In this survey a comparison was made between the vulnerability levels of HHs supporting orphans and those
not supporting orphans. This revealed that HHs supporting orphans had significantly higher vulnerability and
lower food security levels, which could seriously restrict their capacity to support further orphans (table 3.4).

In the first place, HHs supporting orphans had a significantly larger proportion of non earners, 81.0%,
compared to HHs without orphans, 76.2% (Two-tailed t-test; t= -3.206; p= 0.001). The ratio of dependents for
every income earner were 4.2 for HHs supporting orphans, significantly higher than for HHs without orphans,
where there were 3.5 dependents for every income earner (Two-tailed t-test; t= -4.230; p<0.001). These
differences were to be expected given the larger number of orphans dependent on the same pool of income. In
terms of HHs‟ primary sources of livelihood, overall there was little difference, except for salaried income which
accounted for 37% of HHs without orphans, compared to only 23% of HHs with orphans.




Table 3.4 Comparison of Vulnerability levels between HHs Supporting Orphans and HHs not Supporting Orphans.



                                       Households without   Households Supporting   Significant
  Socio-Economic Status                                                                            P - value   Significance Test
                                           Orphans                Orphans           Difference ?


  % Non-earners of HH                        76 .2 %                81 .0 %             Yes         0.001      t-test
  Ratio. Dependents for every Earner         3 .5                   4 .2                Yes        < 0.001     t-test
  Source Income : Salary                     37 %                   23 %                 -            -           -
  Food Consumption Score (Mean)              44 .5                  38 .0               Yes        < 0.001     t-test
  Food Consumption
  [ Poor / Borderline ]
                                             43 .2 %                56 .6 %             Yes        < 0.001     Likelihood Ratio

  Received Food aid / gifts                  44 .0 %                53 .1 %             Yes         0.013      Likelihood Ratio
  Coping Strategy Index (Mean)               37 .7                  51 .7               Yes        < 0.001     t-test




                                                                  15
Average levels of food consumption had fallen significantly from a mean score of 44.5 in HHs without orphans

to 38.0 in HHs supporting orphans (Two-tailed t-test; t= 4.611; p< 0.001). As a result the proportion of HHs

with poor / borderline food security increased significantly from 43.2% of HHs without orphans to 56.6% of

HHs with orphans (Likelihood Ratio chi-square test X2(1) = 13.443, p<0.001). This led to some 53.1% of HHs

with orphans relying on food aid & gifts, significantly more than the 37.7% of HHs without orphans (Likelihood

Ratio chi-square test X2(1) = 6.191, p=0.013).

In addition, there was a significant difference in the extent to which HHs utilised coping strategies to help
support them through periods of food insecurity. HHs supporting orphans had a significantly higher mean CSI
of 51.7 compared to HHs without orphans, with an average CSI of 37.7 (Two-tailed t-test; t=-5.121; p<0.001).
Coping Strategies relied upon heavily included:

   - reducing adult food consumption (74% of HHs with orphans compared to 56% of HHs without orphans)

   - reducing number of meals (74% of HHs with orphans compared to 61% of HHs without orphans)

   - borrowing food from friends/relatives (80% of H-H with orphans compared to 68% of HHs without
      orphans)

Such findings suggest that the capacity of HHs with orphans to respond to shocks & emergencies is very limited.
Given that such a large proportion of HHs have already resorted to drastic coping strategies of reducing their
food consumption, any further shocks or emergencies would go beyond their ability to cope. (However, some of
these figures may have been an over estimate due to the reporting bias of participants who may have preferred
to emphasise their needs in order to secure ongoing food support).


3.1.4.2 Impact of Supporting Paternal, Maternal and Double Orphans upon HH vulnerability

No significant differences were found when comparing the impact of supporting paternal, maternal or double
orphans upon HH vulnerability. As can be seen from table 3.5, whereas the food consumption levels and coping
strategies were negatively affected by the support of orphans, they did not vary much according to whether the
orphans supported were paternal, maternal or double orphans. The one group with the largest fall in livelihoods
were HHs supporting multiple orphans (as indicted in the Senqu valley study). However in this case, the higher
proportion of dependents and reduced income failed to translate into significantly lower food consumption
levels or larger CSI compared to HHs with 1 or 2 orphans.



   Table 3.5 Comparison of Vulnerability Levels between HHs Supporting Different types of Orphans.



                                         HHs without   HHs supporting    Paternal    Maternal    Double        More than
    Socio-Economic Status
                                          Orphans        Orphans         Orphans     Orphans     Orphans       2 orphans


    % Non-earners of H-H                   76 .2 %          81 .0 %        82 .7 %    82 .4 %        80 .2 %     84 .9 %
    Ratio. Dependents for every Earner     3 .5             4 .2           4 .5       4 .4           4 .2        5 .1
    Source Income : Salary                 37 %             23 %           16 %       22 %           29 %        16 %
    Food Consumption Score (Mean)          44 .5            38 .0          38 .0      36 .9          38 .3       36 .3
    Food Consumption
    [ Poor / Borderline ]
                                           43 .2 %          56 .6 %        57 .5 %    56 .0 %        56 .2 %     61 .1 %
    Received Food aid / gifts              44 .0 %          53 .1 %        52 .3 %    62 .6 %        50 .0 %     56 .8 %
    Coping Strategy Index (Mean)           37 .7            51 .7          55 .3      50 .5          49 .7       53 .0




                                                                    16
3.1.4.3 Factors contributing to the reduced capacity of HHs
From the analysis of figures over the last 2 sections, we have concluded that HHs supporting orphans (rather
than different types of orphan) have higher levels of vulnerability to hunger and food insecurity than HHs
without orphans.

What needs to be examined next is whether this is due to: (i) the actual support of orphans, or (ii) vulnerability
which already existed in HHs which are more likely to support orphans (i.e. the female, widowed and elderly
headed HHs). To understand whether it was the impact of caring for orphans or other pre-existing factors
which contributed to the vulnerability of HHs with orphans, a multivariate logistic regression was carried out,
using „Stata 8‟ statistical software.

Factors were examined to find out which contributed significantly in the 2 key areas of vulnerability, lower HH
food consumption and increased use of coping strategies (CSI). Table 3.6 list the factors which were found to
have contributed significantly to poor food consumption and greater use of coping strategies. In this table, a
higher odds ratio indicates factors with a stronger effect upon food consumption & coping strategies. Particular
focus was given to indicators
with an odds Ratio of 2.0 or                       Table 3.6 Multivariate Factors Contributing to Increased
more.                                                                Vulnerability Levels of HHs (using a logistic regression)

In the first case, the key factor                Variables                           Odds Ratio        95% CI          P

found      to    have       contributed
                                                 POOR / BORDERLINE FOOD CONSUMPTION
significantly to both poor and               -
                                                 Ill Member of HH            Yes         1 .7         1.15 to 2.58    0.009

borderline food consumption                                                  No         Referent


was that of HHs headed by a                      Widow Headed HH             Yes         2 .2         1.60 to 2.92   < 0.001
                                                                             No         Referent
widowed person. These were 2.1
/ 2.2 times more likely to suffer                POOR FOOD CONSUMPTION
                                                                      - Yes
from    poor/        borderline      food        Widow Headed HH                         2 .1         1.20 to 3.58    0.009
                                                                        No              Referent
consumption               than       non-
widowed HHs. It is important to                  Quithing District           Yes         0.31         0.14 to 0.69    0.004

note that in this case the                                                   No         Referent


support of orphans did not play                  COPING STRATEGY INDEX
                                             -                               Yes         3 .5        1.15 to 10.70    0.027
                                                 Support Orphan/s
any contributing role towards                                                No        Referent

poor food consumption.                                                        Yes        8 .1        1.07 to 61.36    0.043
                                                 Elderly Headed HH
                                                                             500
                                                                              No       Referent
A second factor contributing
                                                 Mafeting District           Yes         0.34         0.13 to 0.88    0.026
significantly to poor/borderline                                             No        Referent
food consumption was where
                                                 HIGHEST QTR CSI
HHs had a member (or head of                 -
                                                 Support Orphans             Yes         2 .0         1.40 to 2.81   < 0.001
                                                                             No        Referent
the HH) who was chronically ill.
                                                                             Yes         1 .5         1.02 to 2.10    0.039
Given the high prevalence of                     Elderly Headed HH
                                                                             No        Referent
HIV, in most cases chronic
                                                 Ill Member of HH            Yes         1 .7         1.08 to 2.62    0.022
illnesses were HIV & AIDS                                                    No        Referent

related.    Consequently,            HHs         Senqu Valley Area           Yes         1 .6         1.00 to 2.70    0.047
with       vulnerable             children                                   No        Referent


(defined        as        those      with        Mafeting District           Yes         1 .8         1.16 to 2.72    0.008
                                                                             No        Referent
chronically ill parents or HH
                                                                             Yes         0.40         0.19 to 0.83    0.014
members)        were       significantly         Qacha District
                                                                             No        Referent
more    likely       to    suffer    from
poor/borderline                      food



                                                                     17
consumption. These findings illustrate how HIV & AIDS through the loss of a breadwinner can have a
significant impact on the food consumption levels of HHs. They also point to the fact that HHs with vulnerable
children, even before they become orphaned, are in need of food and nutritional support. Another factor which
was mentioned in table 3.6, that HHs located in the Quthing district, were 0.3 times more likely to have poor
/borderline food consumption, meant that actually they were 3.3 times more likely to have good food
consumption and so was discarded.

HHs use of coping strategies were also examined using a multivariate logistical regression, first looking at the
coping strategy index (CSI) mean scores, and secondly comparing the highest quartile of HHs in CSI with the
rest of the population. In both cases, three factors contributed to higher utilisation of coping strategies: (i) HHs
being headed by the elderly, (ii) supporting orphans, and (iii) those with a chronically ill member. HHs headed
by the elderly were 8.1 times more likely to utilise coping strategies, to have a higher CSI. In other words, elderly
headed HHs were 1.5 times more likely to have very high CSI compared to other HHs.

Caring for orphans was found to have a significant effect on HHs resorting to detrimental coping strategies,
though interestingly enough, not on lowering food consumption. HHs supporting orphans were 3.5 times more
likely to resort to utilising more coping strategies and 2.0 times more likely to have the highest CSI compared to
other HHs.

Supporting a chronically ill member in the HH (usually with HIV & AIDS) was also found to have an impact on
high CSI, just as it had on lower food consumption. HHs with a chronically ill member and therefore supporting
vulnerable children, were 1.7 times more likely to have the highest CSI compared to those with healthy
members. In addition, geographical location had some effect on increasing coping strategies. HHs in the Senqu
valley area were found to be 1.8 times more likely to have high CSI than other livelihood zones (southern
lowlands, foothills and mountains). HHs in Mafeteng district were found to be 1.8 times more likely to have
high CSI but then were 2.9 times more likely to have lower CSI. This factor was therefore discarded due to
conflicting results. As were the figures for Qacha‟s Nek district which indicate that HHs were 2.5 times (1/0.4)
more likely not to have high CSI.


In summary, the major factors which contributed significantly to the increased vulnerability of HHs were:

        HHs headed by widows

        HHs headed by the Elderly

        HHs with chronically ill members (therefore supporting vulnerable children)

        HHs caring for orphans

        HHs in the Senqu valley area (though this indicator only occurred in one of 4 findings)


We can therefore conclude that HHs have higher levels of vulnerability & food insecurity (and thus less capacity
to care for orphans) as a result of not only supporting orphans but also other pre-existing factors, mentioned in
the list above.




                                                       18
 3.1.4.4 Households with the Least Capacity to Support Orphans



 Table 3.7 Comparison of Vulnerability Levels between different types of HHs Supporting Orphans.

                                                                             Widowed          Elderly        Chronically ill
                                         HHs without    HHs supporting
    Socio-Economic Status                                                   headed HHs     headed HHs         headed HHs
                                          Orphans         Orphans
                                                                            with Orphans   with Orphans       with Orphans


    % Non-earners of H-H                   76 .2 %           81 .0 %           81 .7 %        80 .4 %           75 .0 %
    Ratio. Dependents for every Earner     3 .5              4 .2              4 .2           4 .1              3 .7
    Source Income : Salary                 36 .8 %           23 .2 %           21 .0 %        25 .8 %           13 .8 %
    Food Consumption Score (Mean)          44 .5             38 .0             35 .3          35 .4             35 .5
    Food Consumption
    [ Poor / Borderline ]                  43 .2 %           56 .6 %           61 .6 %        60 .2 %           69 .0 %
    Received Food aid / gifts              44 .0 %           53 .1 %           56. 8 %        57 .8 %           72 .4 %
    Coping Strategy Index (Mean)           37 .7             51 .7             53 .3          54 .8             64 .0



 To gain further insight into which HHs have the highest levels of vulnerability, and so limited capacity to
 support orphans, the above table 3.7 was compiled, comparing different levels of food security and socio-
 economic status. HHs with orphans, headed by the elderly, widowed, or chronically ill (having vulnerable
 children) did indeed suffer from the highest levels of vulnerability, confirming findings from the multivariate
 analysis in the previous section. Further analysis of different districts and livelihood zones however revealed
 that geographical location has no significant effect upon HH‟s vulnerability.

 The tragedy here is that while these HHs have the least capacity to support orphans, they are in fact the very
 HHs who take in and care for the majority of orphans. As figure 3.5 below shows, 61.7% of HHs supporting
 orphans are headed by widows, while 34.5% are headed by the elderly, and 46.0% are headed by the chronically
 ill (whose children as a result have become vulnerable). In total three-quarters of HHs caring for orphans
 (75.7%) are headed by the elderly, widowed, or chronically ill, the very HHs which lack the capacity to support
 orphans.

 In order for extended families to respond more effectively to the needs of orphans, HHs with greater capacity
 (i.e. lower levels of vulnerability and food security) would need to care for orphaned children, HHs headed by
 married couples, younger adults, with members not suffering from chronic illnesses such as HIV & AIDS.
 Currently as things stand, it is clear that these HHs identified, supporting orphans and headed by the elderly,
 widowed and chronically ill are in great need of further support.




 Fig. 3.5 Proportion of HHs with orphans according to HH heads.




HHs headed by                                          HHs headed                                         Elderly
Chronically ill                                        by Widows                                          Headed
46.0%                                                  61.7%                                              HHs
                                                                                                          34.5%




                                                                                                                               Adult
                                                                                                                               Headed
                                                                                                                               HHs




                                                                       19
3.1.4.5 Household’s perception of their Capacity to Support Orphans
While assessing the capacity of HHs to support orphans, this study also examined how HHs perceived their own
capacity. The majority, 57.3% of HHs surveyed felt that they were not able to support orphans in the future,
compared to 42.7% who felt they were able.

The majority of HHs who said that they could not support orphans in the future were already caring for orphans
at present. 58.0% of HHs with orphans said that they could not care for orphans in the future compared to only
45.5% of HHs without orphans (figure 3.6). In a bi-variate analysis, there was a significant difference, with HHs
currently caring for orphans, 1.7 times less likely to be able to support orphans in the future (Likelihood Ratio
chi-square test X2(1) = 11.227, p=0.001). 83.3% of HHs reported that they did not have enough income and so
couldn‟t afford to support orphans. This tallies with the previous findings, that HHs caring for orphans had
significantly higher levels of vulnerability and so had less capacity to care for more orphans in the future.

A multivariate logistic regression was carried out to discover which factors contributed to respondent‟s
perception that they were not able to support orphans in the future (table 3.8). HHs which were significantly
more likely to feel that they could not support orphans were (i) those currently caring for maternal orphans, and
(ii) HHs headed by widows. Whereas HHs in the Senqu valley and Southern Lowlands, with odds ratios of 0.43
and 0.60 had the perception that they were in fact able to host more orphans in future.




Table 3.8
                                  Variables                           Odds Ratio          95% CI         P
Multivariate Factors
Contributing to HHs               HH with Maternal              Yes       1.9            0.31 to 0.86   0.010
                                  Orphan                        No       Referent
perception of their
                                  Widow Headed HH               Yes       1.6            0.46 to 0.86   0.004
capacity to host                                                No       Referent
orphans in future.
                                  Senqu Valley Area             Yes       0.43           1.44 to 3.84   0.001
                                                                No       Referent

                                  Southern Lowlands Area        Yes       0.60           1.05 to 2.63   0.030
                                                                No       Referent




                                 HH s with Orphans                                  HHs Not Supporting Orphans


Fig. 3.6                                         yes                                            no
                                                                 Have                                     Have
Perception of HH’s                                               Capacity                                 Capacity
                                                                 36 .5%                                   48 .7%
capacity to Support
Orphans




                              No                                             No
                              Capacity                                       Capacity
                              63 .5%                                         51 .3%




                                                           20
3.1.5 Household’s Capacity to Support Orphans in Emergencies
Following the previous assessment of HH‟s capacity to support orphans in general circumstances, this section
will examine their capacity in shocks and emergencies. The IASC (2006) defined an emergency as a situation
that threatens the lives, livelihoods, and well-being of large sectors of the population. In the context of Lesotho,
the most common form of emergency are the recurring periods of severe drought, encountered throughout
2002 – 2005, which decimated food production, resulting in a dramatic increase in food costs, loss of income,
widespread rural poverty and food insecurity. In order to understand whether HHs have the capacity to support
orphans through such emergencies this section will examine household‟s:

     Extent of asset ownership, which could support them through a future crisis.
     Sources of income, and how secure they would be during periods of shocks & emergencies
     Utilisation of coping strategies during normal circumstances to determine whether they could cope in a
       crisis.



     Table 3.9 Proportion of HHs ownership of Assets            Fig 3.7 Primary Sources of Income for all HHs in Survey




                                                                                    Food Ass istance
                                                                                          3.1%
                                                                                                       Re m ittance
                              Own        Not Own                   Salary & Wages                         13.5%
           Assets
                              Assets      Assets                       30.0%
                                                                                                                 Food Production
           Farming Utensils                                                                                      or Sales

           Sickles            44 .2 %    55 .8 %                                                                      15.0%
           Hoes               66 .9 %    33 .1 %
           Handmills          23 .1 %    76 .9 %
           Harrows            17 .0 %    83 .0 %
           Plougs             13 .9 %    86 .1 %
                                                                    Brew ing
                                                                     6.6%                                     Casual Labour
           Domestic Animals
                                                                               Sm all                          19.3%
           Drought Cattle     18 .9 %    81 .1 %                               Business
           Ordinary Cattle    19 .8 %    80 .2 %                                4.4%      Othe r
           Sheep / Goats      29 .7 %    70 .3 %
           Pigs               26 .1 %    73 .9 %
           Poultry            38 .9 %    61 .1 %




Asset Ownership
Household‟s ownership of productive assets were explored in the questionnaire in order to ascertain whether
they had the potential to provide support through a crisis. As outlined in table 3.9, assets covered included
domestic animals and farming utensils (which were a proxy indicator of whether HHs owned fields, not covered
in the questionnaire). With the exception of sickles and hoes, most HHs did not possess any domestic animals
or faming utensils. No significant differences in asset ownership were noted between HHs with or without
orphans.

This indicates that the HHs surveyed are extremely vulnerable to shocks and emergencies, having no back-up /
alternative source of food or livelihood to rely on. Their capacity as a HH to cope or even support orphans
through emergencies would therefore be severely limited. These findings have been noted in other reports such
as the recent one by FAO (2007) which observed that 59% of households in their target area had no vegetable
gardens and were therefore unable to meet food requirements. The WFP-DMA study (2006) of the Southern
Lowlands and Senqu valley reported that a large proportion of poor rural HHs do not have access to agricultural
assets including land.


                                                       21
Income Source
Just under half (44.0%) of HHs depended primarily upon sources of income which would prove unreliable
during an emergency such as widespread drought (figure 3.7). These included food production (15.0%), food
sales, brewing (6.6%), and casual labour (19.3%) - which have proven to be unreliable during a crisis when
economic activity deteriorates and poverty rises. Some 43.5% of HHs, though, relied on sources of income
which are more secure during shocks and emergencies. These included regular salaries from long term
employment (30.0%), and remittances (13.5%) from relatives, mostly working in South Africa.

However there are concerns not only about the sources of HH income, but also the large number of dependents
and lack of income earners in many HHs. This study found that the support of orphans had resulted in a
significantly larger ratio of dependents (4.2) for every income earner compared to HHs without orphans (3.5).
In HHs supporting orphans, as many as 81% of the HH were non-earners. The lack of income earners and
resulting income stability indicates that HHs have limited capacity to cope with a crisis, given that there is no
back-up should the breadwinner fail to support the HH.


Coping Strategies
The multi-variate analysis in section 3.1.4.3 showed how the support of orphans was one of the main factors
contributing to HHs use of detrimental coping strategies. Given the impact that supporting orphans has on
increasing the CSI, most HHs do not have the capacity to support orphans without suffering from a serious
deterioration in their livelihoods. Given the coping strategies already relied upon during general circumstances,
any further shocks or emergencies would go beyond HH‟s ability to cope. The five major coping strategies HHs
resorted to when supporting orphans were:


         Skipping days without eating

         Limiting portion sizes

         Reducing number of meals

         Reducing adult consumption

         Selling assets for food



Summary
These findings suggest that the capacity of HHs to support orphans through shocks & emergencies is limited.
This is mainly due to:

       the lack of productive assets to provide alternative sources of livelihood during a crisis;

       the lack of income earners to support HHs during difficult times coupled with income sources which
          may prove to be very unreliable during an emergency;

       the extent to which HHs already resort to detrimental coping strategies suggests that they would
          struggle to cope in an emergency.




                                                      22
3.2 Informal Social Safety Nets for OVC

From the previous section, it is clear that the majority of HHs have limited capacity to support orphans through
shocks and emergencies given how many are already struggling with unreliable sources of income, limited asset
base and have had to resort to detrimental coping strategies. Clearly there is a need for further support from
other forms of safety nets supporting increasing numbers of OVC. Informal safety nets encompass not only HH
support within the extended family, but also wider community based informal support networks, involving
friends and neighbours.

3.2.1      Characteristics of Informal Safety Nets
Within these informal safety nets, the main forms of support were for food, clothing and financial help. Food
assistance from friends, relatives and neighbours reached almost a quarter of HHs with orphans (24.5%). When
compared to official food aid from WFP & GoL, which reached 14.8% of HHs, this informal safety net was far
more extensive in its support.

However, whereas official food aid was delivered on a monthly
basis, unofficial food assistance was received only occasionally
                                                                         Fig.3.8 Proportion of HHs with Orphans who received
(68.1%). For a quarter of HHs (23.1%), food assistance occurred               .
                                                                                 Food Assistance from Informal Safety Nets.
                                                                              .
only when specifically asked for. Compared to official food aid,
food assistance from family and friends proved to be less reliable,                                         Received Food
                                                                                                            Assistance
especially in emergencies such as draught when the majority of                                              24.5%

friends and neighbours were also struggling with food insecurity.
The main sources of food assistance were primarily from relatives
(64.1% of HHs with orphans), and neighbours (59.9% of HHs with
orphans), though less so from friends (19.0% of HHs with
orphans).                                                                 No Food
                                                                          Assistance
                                                                          75.5%
In terms of financial assistance, 19.1% of HHs with orphans
received    support   from   friends,   relatives   and    neighbours.
Remittances from relatives played a crucial role in financial
assistance, responsible for the primary source of livelihoods in
13.7% of HHs with orphans, and the secondary source of livelihood         Fig.3.9 Frequency of Food Assistance for
in 4.6% of HHs. However only 16.9% of HHs received financial                         HHs with Orphans

support every month, while the majority, 62.0% received it
                                                                                  ..
occasionally, and 19.7% received it only when asked for. Although
financial transfers within families continue to play a major role in
Lesotho supporting vulnerable HHs, there is some concern about            Occassionaly
                                                                          68.1%
their irregular nature and thus the question of whether they could                                                   Every
                                                                                                                     Month
be relied upon in shocks and emergencies.                                                                            8.8%

Informal safety nets also supported 12.4% of HHs with clothing.
For the majority, 78.3% of HHs, this form of assistance also
occurred only on occasions. Other forms of assistance from friends
                                                                                                               Only when
and family covered agriculture (3.0% of HHs), medical (4.6% of                                                 asked for
                                                                                                               23.1%
HHs), and educational (5.1% of HHs) assistance.




                                                          23
3.2.2    Capacity of Informal Safety Nets to support OVC in Emergencies

Clearly from this overview it can be seen that informal safety nets though very active, lack the capacity to
support HHs with OVC in emergencies, due to the irregular, occasional nature of their support. It is
questionable whether they could be relied upon in a serious emergency such as severe drought. Furthermore,
the very people supporting OVC within informal safety nets would themselves be going through same
emergency situation and therefore would be less likely to have the capacity to provide extra support for OVC. As
we have already seen, most HH surveyed had limited asset base, and unreliable sources of income and so would
struggle to sustain themselves through an emergency, not to mention provide extra support to households with
OVC.




                                                     24
3.3 Formal Social Safety Nets for OVC

Formal safety nets encompassed both community support structures, involving the chief, elders, churches and
CBOs, and the more modern, national based safety nets involving the government, NGOs and international
agencies.


3.3.1 Traditional Community Safety Nets

Traditional safety nets which historically were crucial in the support of vulnerable groups during emergency
periods, are no longer very active. Only 0.9% of HHs received financial support from local community based
organisations. In terms of food aid, only 2.3% of HHs with orphans were supported by CBOs. None of the HHs
were supported by the church or other community based stakeholders.


3.3.2 National Safety Nets involved in the Community

Rather than community structures the playing major role in supporting HHs with orphans, this function is
being carried out instead by national safety nets. In terms of overall assistance, most HHs have received support
from national government (72.6% of HHs with orphans) mainly in the area of pensions for the elderly. 24.1% of
HHs with orphans received support from NGOs.

In terms of food aid, the main the main sources of support for
                                                                  Fig.3.10 Sources of Support from Informal Safety Nets
HHs with orphans were WFP (30.7%) and NGOs (48.9%),                 Fig. 3.1 Sources of Assistance from Organisations

who work with WFP as implementing partners for the
delivery of food aid. Only 6.8% of HHs reported receiving                   1.42%
                                                                           Other                       N.G.O

food aid from national government.                                                                     24.06%



In terms of the type of food aid delivered, of the HHs with                                               C.B.O
                                                                                                          0.94%
orphans receiving aid, 97.7% received cereals, and 90.9%
received vegetable oil, while about half, 53.4% received                                                   UN Agency
                                                                                                           0.94%
pulses, 17.0% received CSB, and 12.5% received tinned food.
                                                                   Government
HHs with orphans reported that these rations were received
                                                                       72.64%
mostly under the food for work / assets (45.5%), and home
based care / ART programmes (40.9%).

It was anticipated that whereas food assistance through family and friends suffered from being irregular, formal
food aid would prove to be more reliable. However, only 16.2% of HHs with orphans reported received food aid
on a regular monthly basis. Most of the HHs with food aid, 83.8%, received it only „occasionally‟. The same was
true with other forms of official aid. The vast majority of HHs supporting orphans received most forms of aid on
an occasional basis. Only 8.9% of HHs received assistance for children‟s education on a monthly, while no HHs
received financial help on a regular basis.

Nevertheless one area in which orphans did receive direct support on a daily basis has been through the school
feeding project. 84.9% of HHs reported that the orphans in their care received food on a daily basis at schools.
This is in stark contrast to the 1.3% of HHs who reported that their orphans had been given meals at
friends/relatives and 0.3% whose orphans received food from the church. It can therefore be concluded that out
of the different forms of support, national safety nets through agencies such as the government or WFP have the
largest capacity to support HHs with OVC through emergencies.




                                                     25
4.0 CONCLUSION

This study has found that community based safety nets clearly do not have the capacity to respond effectively to
the needs of orphans during emergencies.


Within the extended family, households caring for orphans were found to have suffered from significantly
higher levels of vulnerability and food insecurity than households without orphans. There is clearly not the
capacity to support more OVC in future without it having a detrimental effect on their livelihoods. The majority
of HHs in the community stated that they were not able to take in more orphans because they could not afford
to support them with their limited sources of income. This is particularly the case during shocks and
emergencies when given their limited asset base, unreliable sources of income and increasing use of detrimental
coping strategies, most households have little reserves to sustain themselves not to mention providing extra
support for orphans.


Household‟s increased vulnerability to poverty and food insecurity were not only due to the burden of
supporting more orphans, but also because the very HHs engaged in supporting orphans were themselves
already some of the most vulnerable, with limited income, few assets and poor food security. The majority of
orphans were supported by single women, often widowed, a third of whom were elderly and many supporting
the chronically ill (as a result of HIV & AIDS). A vicious circle (figure 4.1) has developed whereby the most
vulnerable, food insecure groups have become responsible for supporting orphans which then as a result
become more vulnerable and food insecure. The very people with the socio-economic capacity to support
orphans, including HHs headed by men, married couples and those with regular salaried income, not suffering
from chronic illness, were less likely to be supporting orphans. This situation was similar whether paternal,
maternal, or double orphans, multiple or single orphans were being supported.



               Fig.4.1 Vicious cycle of vulnerability and household’s support of orphans




                       Households which                            Are most likely to
                        are vulnerable                            take in and care for
                       and food insecure                           orphans from the
                                                                    extended family




                                                 Become more
                                              vulnerable and food
                                             insecure as a result of
                                               providing care for
                                                   orphans




The wider informal network of community support from friends and neighbours has been very active, reaching
out to a far larger catchment of households and OVC than official aid. However this form of support is often
irregular and unlikely to be effective during shocks and emergencies, when the very people relied upon to
provide support are themselves struggling to survive in similar situations. Formal safety nets in the community
through traditional institutions involving the chief, elders, churches and other community based organisations


                                                           26
have failed to be very effective. Therefore ,outside the extended family, the main forms of safety net relied upon
to meet the needs of OVC have been the national systems of official support implemented by the government,
WFP, NGOs and other international agencies.


The Government‟s provision of a monthly pension for the elderly has played a major role in supporting many
HHs caring for orphans. The food security of orphans has been largely ensured through the provision of food
aid at schools, distributed by the WFP and a network of implementing agencies. Unless there is a strengthening
of the role played by community support structures, the basic needs of orphans will continue to depend upon
the support of outside agencies to help guarantee their livelihoods throughout emergencies.


Table 4.1 below provides a summary of the capacity and sustainability levels of these key safety nets to support
orphans in the future.




Table 4.1 Capacity & Sustainability levels of Safety Nets to Support Orphans


                                               Formal                                        Informal
         Safety Net
                                    Modern              Traditional             Community               Familial

                                     GoL,            Elders & Chiefs,          Neighbours &       Extended Family
          Provider
                                 Int. Agencies       Church & CBOs                Friends           Households

                                 Low-Medium
  No. Orphans Reached                                    Low Nos.                High Nos.         Very High Nos.
                                    Nos.
   Level of Vulnerability             Low                 Medium               Medium - High             High
    Capacity to Support
                               Medium - High          Low - Medium             Low - Medium              Low
      more Orphans
   Sustainability through
                                     High                 Medium               Low-Medium                Low
       Emergencies
    Deterioration due to
                                Ltd - Moderate           Moderate                  Severe               Severe
       HIV & AIDS
                                                                                                    Ltd. without
      Future Potential          Internationally        Opportunities           Some Potential
                                                                                                      Support




                                                            27
5.0 RECOMMENDATIONS


5.1 Interventions by the World Food Programme

    Targeting of food aid

       WFP‟s provision of food aid to OVC needs to focus more specifically on the most vulnerable
        households, as identified in the survey, i.e. those whose heads of HHs who are elderly, widowed, and
        chronically ill. Although child-headed households are also one of the most vulnerable groups, as of
        yet they are still few in number.

       Households not supporting orphans but found to be equally vulnerable should also be considered for
        food support. This would especially apply to HHs with chronically ill parents, whose children as a
        result have been made „vulnerable‟ and in the near future are likely to be orphaned. The targeting of
        households needs to be based more directly on their levels of vulnerability rather than whether they
        support orphans, which is at times based on the false assumption that only these HHs are the most
        vulnerable and food insecure.

       Based the findings of this study, targeting of food aid should not differentiate between whether
        orphans are single or double, paternal or maternal, given that no significant differences were
        identified between the vulnerability levels of HHs supporting these groups. Similarly, this study
        recommends that food aid should not target one district or livelihood zone over another in the
        Southern lowlands and Senqu valley as the livelihoods of HHs supporting orphans in all areas were
        found to be equally vulnerable.

    Strengthening of Informal Safety Nets in the Community

       There needs to be a shift in focus within WFP beyond that of solely providing food aid, to help
        strengthen safety nets (in collaboration with GoL, UNICEF, FAO, and other agencies) which can be
        sustainable in the future, long after the departure of WFP from Lesotho. Otherwise, as WFP
        continues to supply food aid in bulk across the Southern lowlands and Senqu valley during drought
        periods, there is the risk that this will be creating an attitude of dependency.

       Strengthening HH safety nets for emergencies requires significant improvements to their asset base
        and income stability. Without an improvement in these areas, HHs will continue to be rendered
        vulnerable and food insecure through reoccurring droughts and will be repeatedly dependent upon
        emergency relief supplies from WFP.

       Consequently interventions to expand HH‟s productive assets need to be scaled up, particularly in the
        utilisation of domestic livestock, and conservation agricultural techniques for vegetable and cereal
        production. This work has been carried out in the last few years by agencies such as the FAO, World
        Vision, Red Cross, Catholic Relief Services, CARE etc, but currently benefits only a fraction of
        households and desperately needs to be expanded on a national scale, with the help of agencies such
        as WFP to significantly strengthen these community based safety nets through periods of drought. In
        this way HHs are more likely to have sufficient reserves of food to not only sustain their own food
        security through emergencies, but also be able to care for orphans, and provide an informal safety net
        for vulnerable households with orphans. In addition maintaining these assets could help to provide
        alternative sources of income during crises or in cases where the breadwinner may become
        chronically ill with HIV & AIDS.




                                                    28
5.2 Interventions by the GoL, NGOs & International agencies

    Strengthening of Informal Safety Nets in the Community

         Alongside the above interventions, to effectively strengthen community and household safety nets, an
          educational & advocacy campaign would also be needed to bring about two major changes. First an
          educational campaign to bring about a change in attitudes of many HHs to prioritise not only the
          generation of wealth but more so the development sustainable livelihoods through larger asset base
          and alternative sources of income to withstand the impact of shocks and emergencies. Secondly, an
          advocacy campaign to encourage HHs with better socio-economic capacity to become more active in
          taking in and caring for more orphans.


        Strengthening of Formal, Traditional Support Structures in the Community

         Strengthening the capacity of community support structures including CBOs, the church, the chief
          and community elders to respond to the needs of OVC would require long term intervention
          facilitated by the new decentralised local government, working closely together with international
          agencies and NGOs. This would need to involve providing resources, financial assistance and
          technical guidance to community based organisations along similar lines to the way in which home
          based care work has been developed across the country. As a result, strengthened community safety
          nets could help to fill the gap in the support of OVC especially in rural areas where national safety
          nets are failing to be effective.




                                                    29
Appendix 1.     SAMPLE DISTRIBUTION



                                                                                                    No. of
     District    Constituency         Council            Livelihood Zone           Village        Households
                                                                                                   with OVC
                                                         Southern Lowland       MAKHEMENG
                 Thaba Pechela     Metse Moholo
                                                         Southern Lowland         KALICHA
                                                         Southern Lowland       HA PHECHELA
                 [High % of OVC]       [Rural]
                                                         Southern Lowland        HA KEKETSI           35
                                                         Southern Lowland     BERA HA MASUPHA        69
                                                         Southern Lowland        HA 'NGOAE           39
                Thabana Morena      Koti Sephola         Southern Lowland        HA MOFOKA           43
                                                         Southern Lowland        HA KHOETE            19
    Mafeteng
                                                         Southern Lowland        HA KONOTE           83
                                                             Foothills          HA RASEBOKO
                 [High % of OVC]       [Rural]
                                                             Foothills            MAISANE
                                                             Foothills           HA LETSOTA
                                                         Southern Lowland       MATHOLENG            70
                   Mafeteng         Makaoteng
                                                         Southern Lowland       PHAHAMENG            106
                                                         Southern Lowland         LEH COOP           87
                  [Low % of OVC]     [Peri-Urban]
                                                         Southern Lowland      HA RAMOKHELE           18
                                                         Southern Lowland       MATSATSENG           78
                    Qhalasi         Mashaleng
                                                         Southern Lowland       MAJAKANENG           30
                 [High % of OVC]       [Rural]               Foothills            HA TSEPO           29
                                                         Southern Lowland       MAJAPERENG            35
                                                                                  RALINEO             47
                 Mohale's Hoek      Motlejoeng
    Mohale's                                                                      KANTINI             11
     Hoek
                                                         Southern Lowland      HA KOBO-TS'OEU
                  [Low % of OVC]     [Peri-Urban]
                                                                                  HA TLALI           22
                                                                                 HA QACHA            34
                    Qaqatu           Phamong
                                                         Senqu River Valley      HA LELIMO            13
                                                             Foothills           HA SETEKE            5
                 [High % of OVC]       [Rural]
                                                         Senqu River Valley      HA KHOBO             7
                                                         Senqu River Valley       LEQENE              21
                      Tele          Likhohlong
                                                            Mountains              HA QOI             27
                                                            Mountains            SEKAKENG            66
                 [High % of OVC]       [Rural]
                                                                                  TSEKONG             12
                                                         Senqu River Valley        HA ELIA           42
                    Moyeni         Qomoqomong
                                                            Mountains             HA KOMPI            6
     Quthing
                                                         Senqu River Valley      HA RATLALI           21
                  [Low % of OVC]       [Rural]
                                                                                 RAMOSOEU            33
                                   Mokotjomela           Senqu River Valley       HA FAKO             8
                Mount Moorosi
                                                         Senqu River Valley      HA MOQALO           20

                                     [Peri-Urban]
                                                                                 HA KARABEI          58
                 [High % of OVC]
                                                                               MOSUTUTSONG           54
                                      Letloepe                                HA HLAPALIMANE
                                                            Mountains           MAPHELENG             17
                  Qacha's Nek          [Rural]
                                                            Mountains              TOPA              24
                                                                              MAKHALING MOTSE-
                                     White Hill             Mountains             MOCHA              28
     Qacha's
      Nek        [High % of OVC]                            Mountains         WHITE HILL TIPING      42
                                       [Rural]
                                                            Mountains           HA MANTEKO            9
                                                            Mountains            MELIKANE             6
                    Tsoelike       Thaba Litsoene
                                                            Mountains             HA ISAAC            6
                  [Low % of OVC]       [Rural]                                    LIKILENG            17
                                                                                   TOTAL             1397

                                                    30
Appendix 2.        STRUCTURED INTERVIEW GUIDE

In this area it will be important to understand various issues that affect governance, coordination, implementation
and support by various levels of government in the country, down to the community level.


The following is a list of questions that may need to be asked during consultations with key informants and
stakeholders. It is cautioned that this list is only indicative, not exhaustive. It will be developed further during
consultations and the actual undertaking of the survey.


    1.   Is this a permanent body?

    2.   What support is provided for people living with HIV/AIDS and OVC by your organisation?

    3.   How effective would you rate your coordination?

    4.   How do you select your beneficiaries?

    5.   Where is this organisation implementing their projects?

    6.   Is the community fully involved in your projects (even selection of beneficiaries)?

    7.   How do you get funding for your activities?

    8.   What are your greatest challenges?

    9.   What impact does your activity have on the livelihood of the community?

    10. How does the community access your services?

    11. Does the community know about your services?

    12. What is the sustainability of these project/programmes?

    13. Is this organisation prepared to accommodate the rising number of orphans (any future plans to carter for

         rising number of OVC)?

    14. What are the things you are happy about?

    15. If you were to change anything what would it be, and how would you change it?

    16. How would you rate the adequacy of financial resources to combat HIV/AIDS?

    17. In your view is government soliciting funds for orphans and other children made vulnerable by HIV/AIDS

         from the international community.

    18. What are the current safety nets and do you think traditional safety nets still exist within the community?

    19. If not what has let to the changes?

    20. Do you think the existing social safety nets and traditional safety nets are addressing the needs of OVCs?

    21. Do you think the community have the capacity to care for OVC?




                                                       31
Appendix 3.       HOUSEHOLD QUESTIONNAIRE




                    District_________________________________ |__|__|


                    Constituency_____________________________|__|__|


                    Community Council________________________|__|__|


                    Village__________________________________|__|__|


                    Livelihood Zone___________________________|__|__|


                    Date of interview                          |__|__|__|__|__|__|
                                                               Day    Month    Year




Guidance for introducing yourself and the purpose of the interview:

    My name is _____ and I work for _________ (NGO name/WFP).

    Your HH has been selected because it hosts a child/children who are orphaned in the area.

    The survey is voluntary and the information that you give will be confidential. The information will
     be used to prepare reports, but neither your, nor any other names, will be mentioned in any
     reports. There will be no way to identify that you gave this information.

    Could you please spare some time (around 40 minutes) for the interview?




NB to enumerator: DO NOT suggest in any way that HH entitlements could depend on the
outcome of the interview, as this will prejudice the answers.




Respondent should be HH head or spouse of HH head.




                                                   32
                                                  Section A: HH Demographics

 A1a    Name of Respondent (for record only):        _______________________________

 A1b    Sex of Head of HH                         1 = Male                                                         2 = Female

 A1c    Age of Head of HH                         Age in years:   |__|__|

                                                  1 = Married                                             4 = Living apart, not divorced

 A2     Marital status of Head of HH              2 = Partner, not married                                5 = Widow or widower

                                                  3 = Divorced                                            6 = Never married

        Total Number of People Living in              Males          0 to 5: |___|       6-17: |___|      18-59: |___| 60+ |___|
        the HH
 A3
                                                    Females          0 to 5: |___|       6-17: |___|      18-59: |___| 60+ |___|
                      |__|__|

        How long have you stayed at your
 A4                                               < 1 year           1-2 yrs         2-5 yrs                  5 – 10 yrs        10 yrs +
        current residence?

                                                                                     Stay with friends/
 A5     How do you obtain your housing?           Own        Rent    Borrow                                   Casual labour     Other
                                                                                     relatives

        Are all of your children aged 6-17 attending                                                             Females: 1 = Yes       0=
 A6                                                          Males: 1 = Yes       0 = No
        schools regularly?                                                                                       No

        Have any of your children aged 6-17                                                                      Females: 1 = Yes       0=
 A7                                                          Males: 1 = Yes        0 = No
        dropped out of school?                                                                                   No

        What are the main reasons for dropping                                   Males                                     Females
 A8     out? (up to 2 most important reasons
        each)                                                         |__|__|            |__|__|                 |__|__|        |__|__|
                                                             7 = School Expensive/no money

        1 = Illness                                          8 = Child considered too young to go to school

        2 = Job                                              9 = Pregnancy/
Codes   3 = Help with HH work                                10 = marriage
 for
 A6:    4 = Care for ill member/younger sibling              11 = School not available

        5 = Not interested in school                         12 = Did not qualify to next grade

        6 = Distance to school is too far                    13 = No second reason

                                                             88 = Other

A9a Ca 1     Age Sex Stat      W Len Rela
    n        |__| |__| us      he gth tion
    yo                 |__     n of ship
    u                  |       di stay [__
    giv                        d [__ _]
    e                          th _]
    m                          e
    e                          pa
    th                         re
    e                          nt
    ag                         /s
    e,                         di
    se                         e
    x                          (y
    an                         ea
    d                          r)?
    or                         [_
    ph                         __
    an                         _]
    st                         [_
    at                         __
    us                         _]
    for
    ea
    ch
    or
    ph
    an
    ?(
    1
    =                                                               33
    Bo
    y
    2
    =
                                                      Age Sex Stat W Len Rela
                                                        2
                                                      |__| |__| us
                                                      Age Sex Stat he gth tion
                                                        3            W Len Rela
                                                      Age Sex us
                                                      |__| |__| |__ n of ship
                                                        4            W Len Rela
                                                                Stat he gth tion
                                                      |__| |__| |
                                                      Age Sex |__ di stay [__
                                                        5       Stat n of ship
                                                                us   W Len Rela
                                                                     he gth tion
Codes for orphan status     1 = Father alive                  2 |__ d [__ _]
                                                                =
                                                      |__| |__| | Mother alive
                                                                us   di stay [__
                                                                     n of ship
                                                                     he gth tion             3 = Both parents dead
                                                                |    n of
                                                                     di stay ship
                                                                     d [__ [__
                                                                |__ th _] _]
                            1-3mnths = 1, 4-6mnths = 2, 7-9mnths = 3, 10-12mnths = 4
Length of Stay                                                  |    e _] _]
                                                                     d stay
                                                                     di
                                                                     th [__ [__
                                                                     th
                                                                     d
                                                                     pa _] >5yrs = 9
                                                                     e [__
                            1-2yrs = 5, 2-3yrs = 6, 3-4yrs = 7, 4-5yrs = 8, _]
                                                                     th
                                                                     re _]
                                                                     pa
                                                                     e
Codes for relationship      1 = mother 2 = Father 3 = Grandmother 4 = Uncle 5 = Aunt 6 = sister
                                                                     pa
                                                                     re
                                                                     e
                                                                     nt
& A7d                       7 = brother 8 = friend 9 = other         re
                                                                     nt
                                                                     /s
                                                                     pa
                                                                     di
                                                                     nt
                                                                     /s
                                                                     re
                                                                     nt
                                                                     e
                                                                     /s
                                                                     di
                                                                     /s
                                                                     di
                                                                     (y
                                                                     e
          Would you be able to host more orphans?                    ea
                                                                     e
                                                                     (y
                                                                     di
                                                                     (y
                                                                     ea
                                                                     e
                                                                     r)?
                                                                     r)?
                                                                     ea
                                                                     (y
                                                                     [_
   A9b    (For child headed HHs, skip to A9f)                                        1 = Yes    0 = No
                                                                     [_
                                                                     r)?
                                                                     ea
                                                                     __
                                                                     [_
                                                                     r)?
                                                                     __
                                                                     _]
          (if no skip to A9f)                                        _]
                                                                     [_
                                                                     __
                                                                     __
                                                                     _]
                                                                     [_
   A9c    If not, why?                                               __
                                                                     _]
                                                                     [_
                                                                     __
                                                                     [_
                                                                     _]
   A9d    Would you be willing to host more orphans?                 __
                                                                     _]
                                                                     _]
           In case the head of HH is no longer able to care for the children, whose
   A9f
           responsibility would it be to take care of these children?

           Have any of your economically productive HH members (18-59 years)                                  1 = Yes
           been chronically ill and unable to work? (Chronic illness refers to a
   A10
           continuous illness that reduces the productivity of individual for a
           period of 3 months or more)                                                                 0 = No (skip to A 11)


   A11     What are the ages and sex of the chronically ill HH members?                                    Age |__|__|

                                                                                Age |__|__|                   Sex |__|

                                                                                Age |__|__|                   Sex |__|




                    1 = Can not afford to feed extra                        1     = Yes
                    people
                                                                            2     = Yes, with extra income
                    2 – Too sick to care for extra people
                                                                            3     = Yes, if given allowance
  Codes for         3- Do not have enough income
                                                            Codes for A9e   4     = Yes, if given other support
  A9c:              4- Cannot afford more school
                    expenses                                                5     = only if I had to

                    5 - Not enough space in my home                         6     = No, don’t want to

                    5- Other                                                7     = No, already caring for too many people




                                                               34
                                                                                                           1 = Yes
              Is the chronically ill member one of the main income earners for your
      A10
              HH?
                                                                                                           0 = No

                                                                                                           1 = Yes
      A11     Have any members of your current HH joined in the last 6 months?
                                                                                                           0 = No

                                                                                                           1 = Yes
      A12     Are any members of your current HH left in the next three months?
                                                                                                           0 = No

              Have any of your HH             1 = Yes              Was this person                          1 = Yes
    A13a      members died in the                                  chronically ill before
              past 3 months?             0 = No (skip to A14)      dying?                                    0 = No

                                                                                              1 = Yes
    A13b      Did a main income earner die?
                                                                                               0 = No

                                                                        Children (6-17)                      |__|
              How many persons in your HH who are 6 years
      A14     or older are engaged in some type of economic             Adults (18-59)                       |__|
              activity?
                                                                        Elderly (60+)                        |__|

                                    Section B. HH income, external support and debt

Please complete the table, one
                                       During the past 6 months, what were your HH’s most important livelihood sources? (use
activity at a time, using the
                                       activity code, up to 3 activities)
livelihood source codes below

B1a     Most important                                                            |__|__|

B1b     Second                                                                    |__|__|

B1c     Third                                                                     |__|__|
                                       6 = livestock production/sales                       13 = mineral panning
Livelihood source codes:
                                       7 = skilled trade/artisan                            14 = vegetable production/sales
1 = remittance
                                       8 = small business                                   15 = Food assistance
2 = Food crop production/sales
                                       9 = petty trade (firewood sales, etc.)               16 = No other source
3 = Cash crop production
                                       10 = brewing                                         17 = Micro Finance (Stockvel)
4 = casual labour/Braiding
                                       11 = formal salary/wages/rent                        18 = Pension
5 = begging
                                       12 = fishing                                         88 = Other




                                                                   35
                                                                 4 = Educational
                                                  1 = Money
                                                                 support           7 = Farm inputs

      During the past 6 months, has your HH
      received any of the following type of       2= Food                          8 = Other
B2                                                               5 = Medical
      support from relatives / friends? (circle
                                                                 expenses
      all that apply)

                                                  3 = Clothing                     9 = None (skip to b5)

     B3 How 1 =      2=      3=       7=
        ofte Mon     Foo     Clot     Far
        n    ey      d       hing     m
        did                           inpu
        you                           ts
        r
        HH
        rece
        ive
        this
        sup
        port
        ?
        (Sel
        ecte
        d in
        B2)


              5=             4=       8=
              Med            Edu      Oth
              ical           cati     er
              exp            onal
              ens            sup
              es             port


     B4 Do 1 =       3=      5=       7=
        you Mon      Clot    Med      Far
        exp ey       hing    ical     m
        ect                  exp      inpu
        to                   ens      ts
        cont                 es
        inue
        to
        rece
        ive
        this
        sup
        port
        ?
        (1=
        Yes
        0=
        No)


              2=     4=               8=
              Foo    Edu              Oth
              d      cati             er
                     onal
                     sup
                     port




                                                            36
          During the past 3 months, did you or any                                                                      0 = No
B5                                                                              1 = Yes
          member of your HH borrow money?                                                                         (skip to Section C)

          What was the primary reason for                    1 = to buy food                             2 = pay for health care

B6        borrowing?                                         3 = pay for funeral                         4 = pay for social event
          (Circle one only)                                  5 = buy agric inputs                        6 = pay for education

          From whom did you borrow?                          1= friend/relative                          2 = money lender
B7
          (Circle one only)                                  3 = bank/formal lending institution         4 = informal savings group

Codes for B3: 1=Every month, 2=Occasionally (not regular), 3=Only when asked for, 4=Only started

                                                 1 = Food                                         2 = Clothing

                                                 3 = Farm inputs                                  4 = Loans
           Did your HH receive assistance
 B8                                              5 = Agricultural skills training                 6 = Cash
           from any other organizations?
                                                 7 = Other skills training                        8 = Educational support

                                                 9 = Old age pensions                             10 = Other

                                                 1 = NGO                                          2 = CBO
           From which Organisation did
 B9                                              3 = UN Agency                                    4 = FBO
           you receive assistance
                                                 5 = Government                                   6 = Other


                                                            Section C. Expenditure


  Did you spend money on [item] last 30
                                                     Estimated expenditure                                          Estimated expenditure
  days for domestic consumption?
                                                     during the last month in                                       during the last month in
                                                     LOCAL CURRENCY                                                 LOCAL CURRENCY
  If none, write 0 and go to next item


  C1               Food                                                              C4   Soap and HH items

  C2               Transport                                                         C5   Alcohol & Tobacco

  C3               Fuel (wood, paraffin, etc.)                                       C6   Other

                     In the past 3 Months how much money have you spent on each of the following items or service?
                     Use the following table, write 0 if no expenditure.
                                                            Estimated expenditure in LOCAL CURRENCY

     C7              Medical expenses, health care

     C8              Clothing, shoes
                     Equipment, tools, seeds,
     C9
                     animals
     C10             Construction, house repair
                     Hiring labour (not for house
     C11
                     repair/construction)
     C12             Debt repayment

     C13             Rent
                     Education, school fees, uniform,
     C14
                     etc
     C15             Celebrations, social events
                     Funerals (incl. burial society
     C16             fees & burial of HH members
                     only)

                                                       Section D. Coping Strategies
  In the past 30 days, how frequently did your HH resort to using one or more of the following strategies in order to have access
  to food? CIRCLE ONLY ONE ANSWER PER STRATEGY.




                                                                         37
                                                                                                                    Often
                                                                          Seldom            Sometimes
                                                         Never                                                  (3-6 days a
                                                                                                                                       Daily
                                                                      (1-3 days/month)   (1-2 days /week)
                                                                                                                   week)

D1              Skip entire days without eating?          1                  2                  3                    4                  5

D2              Limit portion size at mealtimes?          1                  2                  3                    4                  5
                Reduce number of meals eaten per
D3              day?
                                                          1                  2                  3                    4                  5

                Borrow food or rely on help from
D4              friends or relatives?
                                                          1                  2                  3                    4                  5

                Rely on less expensive or less
D5              preferred foods?
                                                          1                  2                  3                    4                  5

D6              Purchase/borrow food on credit?           1                  2                  3                    4                  5
                Gather unusual types or amounts of
D7              wild food / hunt?
                                                          1                  2                  3                    4                  5

                Harvest immature crops (e.g. green
D8              maize)?
                                                          1                  2                  3                    4                  5

D9              Send HH members to eat elsewhere?         1                  2                  3                    4                  5

D10             Send HH members to beg?                   1                  2                  3                    4                  5
                Reduce adult consumption so
D11             children can eat?
                                                          1                  2                  3                    4                  5

D12             Rely on casual labour for food?           1                  2                  3                    4                  5
 Coping strategies (not part of CSI)

                                                                            1        =       Yes,           2   =        Yes,   non-
                                                                            productive                      productive
      D13          Have you sold any HH assets to buy food?
                                                                            3    =   Yes,   both
                                                                                                            4 = No
                                                                            types

                                                                            1        =       Yes,           2   =        Yes,   non-

                   Have you sold any HH assets to pay for health            productive                      productive
      D14
                   care/medical expenses?                                   3    =   Yes,   both
                                                                                                            4 = No
                                                                            types

                                                                            1        =       Yes,           2   =        Yes,   non-

                   Have you sold any HH assets to pay for school            productive                      productive
      D15
                   fees and other school related expenses?                  3    =   Yes,   both
                                                                                                            4 = No
                                                                            types

                                                     Section E. Food Consumption

                                                                                                                    |__|
      E1        How many meals did the adults (18+) in this HH eat yesterday?
                                                                                                        NUMBER OF MEALS

                                                                                                                    |__|
                How many meals did the adolescents (5-17) in this HH eat
      E2
                yesterday?
                                                                                                        NUMBER OF MEALS

                                                                                                                |__|__|
                How many meals did the children (6-59 months old) in this HH
      E3
                eat yesterday? IF NO CHILDREN IN THE HH, WRITE 98 for N/A
                                                                                                        NUMBER OF MEALS

          Did your HH consume this food yesterday?

          Over the last seven days, how many days did your HH consume the following foods?

          What was the main source (primary & secondary) of the food in the past seven days?




                                                                 38
                                                                                               Number of days      Primary
                                                                Did your HH consume             in the last 7      Source
                                                                                                    days                             Second Source
                                                                this food yesterday?
                                                                                                   (0 to 7)

                                                                                                                        |__
            1. Maize, maize porridge                                1 = Yes        2 = No          |__|                                 |__|
                                                                                                                        |
            2. Other cereal (rice, sorghum, millet, etc),
            bread and pasta
                                                                  1 = Yes        2 = No             |__|             |__|                   |__|

            3. Roots & tubers (cassava, potatoes, sweet
            potatoes)
                                                                  1 = Yes        2 = No             |__|             |__|                   |__|

            4. Sugar or sugar products                            1 = Yes        2 = No             |__|             |__|                   |__|
            5. Beans and peas                                     1 = Yes        2 = No             |__|             |__|                   |__|
            6. Groundnuts and cashew nuts                         1 = Yes        2 = No             |__|             |__|                   |__|
            7. vegetables (incl. relish & leaves)                 1 = Yes        2 = No             |__|             |__|                   |__|
            8. Fruits                                             1 = Yes        2 = No             |__|             |__|                   |__|
            9. Beef, goat, other red meat and pork                1 = Yes        2 = No             |__|             |__|                   |__|
               10. 1 =      |_ |_ |_
               Poul Yes
                            _| _| _|
               try 2 =
                    No


11. Eggs                                              1 = Yes      2 = No              |__|               |__|              |__|
12. Fish                                              1 = Yes      2 = No              |__|               |__|              |__|
13. Oils/fats/butter                                  1 = Yes      2 = No              |__|               |__|              |__|
14. Milk/yogurt/other dairy                           1 = Yes      2 = No              |__|               |__|              |__|
15. CSB                                               1 = Yes      2 = No              |__|               |__|              |__|

            Source codes:      1 = From own production                  2 = Casual labour
                               3 = Borrowed                             4 = Gift
                               5 = Purchases                            6 = Food aid
                               7 = Barter                              8 = Hunting/gathering/fishing


                                                            Section F. Food Assistance
                                                                                                                     Gifts only (Friends
                                                                                             Food Aid Only –
                                                                                                                        Neighbours,
                                                                                            (answer F2 and
                                                                                                                      Relatives, Etc) –
                                                                                                  F4)
                                                                                                                    (Go t0 F3 and F4)
                              Did your HH receive food gifts/aid at any time
                       F1
                              during the last 6 months?                                   Both Food Aid and
                                                                                                                            None
                                                                                                Gifts
                                                                                                                  (Answer only F2a,
                                                                                          (Answer both F2,
                                                                                                                    F3a, and F4)
                                                                                             F3, and F4)
                                                                                       1 = Friends, relatives,    5 =-Did not want
                                                                                       and neighbours unable to
                                                                                       help

                            In your opinion, why have you not received any Gifts?      2 = Stigmatised            6 = Friends, relatives,
                   F2a                                                                                            neighbours, refuse to
                                        (CIRCLE ALL THAT APPLY)                                                   help

                                                                                       3 = Did not need           7 = did not need
                                                                                                                  because receiving food
                                                                                                                  aid




                                                                            39
                                                                 4 = Do not know              8 = Other


                                                                 WFP                          CBO
      From whom do you receive food aid from? (circle all
F2b                                                              NGO                          Government
      that apply)
                                                                 Church                       Other

                                                                 1 = Cereals   |__|           2 = Pulses    |__|

F2c   What type of food did you receive through food aid?
                                                                 3 = Oil   |__|               4 = CSB     |__|
                                                                 5 = Tinned Foods
                                                                 |__|                         5 = Other     |__|

                                                                 1 = FFW/FFA/FFT              2 = HBC/ART/PMTCT/
      Under which programme did your HH receive the
F2d                                                              3 = OVC                      4 = GFD/TFD/VGF
      ration? (circle one)
                                                                 5 = MCH                      6 = Clinics

      Did you sell or barter any food aid     1 = Cereals   |__|                    2 = Pulses   |__|
      last month?
F2e
      (1 = Yes; 2 = No)
                                              3 = Oil   |__|                        4 = CSB    |__|
                                              5 = Tinned Foods     |__|             5 = Other    |__|
      What did you sell/barter it for?
F2f
      (see codes below)


                                              1 = Cereals   |__|                    2 = Pulses   |__|
      If yes, how much?
F2g                                           3 = Oil   |__|                        4 = CSB   |__|
      (see codes below)
                                              5 = Tinned Foods     |__|             5 = Other    |__|
      Did you share/give away any food aid    1 = Cereals   |__|                    2 = Pulses   |__|
      last month?
F2h                                           3 = Oil   |__|                        4 = CSB    |__|
      (1 = Yes; 2 = No)
                                              5 = Tinned Foods     |__|             5 = Other    |__|
      If yes, how much?                       1 = Cereals   |__|                    2 = Pulses   |__|
F2i   (See codes above)                       3 = Oil   |__|                        4 = CSB    |__|
                                              5 = Tinned Foods     |__|             5 = Other    |__|
      How many days did your most recent
F2j
      ration of CEREALS last?
                                                                  Number of days          |__|__|

                                                Very Important                      Somewhat important


F2k   How important is food aid to your HH?
                                                Not important



                                                                 1 = Absent during food       5 =-Eligible, but biased
                                                                 aid distribution             against

                                                                 2 = Am not registered for    6 = Not enough food
      Why have you not received any food aid?                    food aid
F3a
                   (CIRCLE ALL THAT APPLY)                       3 = Did not need             7 = Other

                                                                 4 = Do not know


                                                                 1 = Relatives                2 = Neighbours
      From whom do you receive food gifts from? (circle all
F3b
      that apply)                                                3 = Friends                  4 = Other

      Did you sell or barter any food gifts   1 = Cereals   |__|                    3 = Oil   |__|
F3c   last month?




                                                    40
       (1 = Yes; 2 = No)
                                                      2 = Pulses      |__|                       4 = Fruits/Vegetables        |__|

                                                      5 = Tinned Foods       |__|                6 = Other    |__|

F3d    What did you sell/barter it for?

                                                      1 = Cereals      |__|                      3 = Oil   |__|
       If yes, how much?
F3e
       (see codes below)                              2 = Pulses      |__|                       4 = Fruits/Vegetables

                                                      5 = Tinned Foods                           6 = Other    |__|

                                                                   Very Important                    Somewhat important
F3f    How important are these gifts to your HH?
                                                                   Not important


                                                                                                     Friend / relative / neighbour
                                                                   School feeding   |__|             |__|
       Have any of the orphaned children received
       meals under any of the following programmes
F4a    / sources in the past 3 months? (Tick if ‘yes’)                     Clinic   |__|                   Support Group     |__|

       (if did not receive skip to section G)                              NGO      |__|                       Church   |__|
                                                                           Other    |__|                   Did not receive   |__|

                                                                                                     Friend / relative / neighbour
                                                                   School feeding   |__|             |__|

F4b    How often does he or she receive these meals                        Clinic   |__|                   Support Group     |__|
                                                                           NGO      |__|                       Church   |__|
                                                                           Other    |__|
                                                                          Very important                   Somewhat important
F4c        Are these meals important for the HH?
                                                                          Not important

           Codes for F2c/F2e and F3c/F3e:           1 = all   2 = More than ½         3 = Half     4 = Less than half

Codes for F2d and F3d: 1= Food (other) 2= Cash 3= School Fees/related expenses 4 = Clothing 5= Farm Inputs 6 =
                                                   Other

  Codes for F4b: 1 = daily 2 = Weekends only 3 = Sundays only 4= holidays only 5 = once in a while / irregularly




                                      Section G. HH assets and livestock
        How many of the following assets are owned by you or any member or your HH?
G1
                                   IF A SPECIFIC ASSET IS NOT OWNED, ENTER’ 0’

           Non-productive Assets                                      Productive & Transport Assets

        1. Chair                 |__|           8. Axe                         |__|         15. Hand Mill                    |__|
        2. Table                 |__|           9. Sickle                      |__|         16. Bicycle                      |__|
        3. Bed                   |__|           10. Panga/Machete              |__|         17. Harrow                       |__|
        4. TV                    |__|           11. Mortar                     |__|         18. Plough                       |__|
        5. Radio                 |__|           12. Hoe                        |__|         19. Sewing machine               |__|
        6. Refrigerator          |__|           13. Ox Cart                    |__|         20. Hammer Mill                  |__|
        7. Mobile phone         |__|            14. Tractor                    |__|         21. Fishing nets                 |__|
                                                                                            22. Boat (Sekeiti)               |__|
G2      In the past 3 months, did your HH purchase any assets?                                    1 = Yes               0 = No




                                                              41
     How many of the following animals do your family own?


G3   Draught cattle   |__|__|              Cattle   |__|__|               Donkeys/Horses     |__|__|

     Sheep/goats    |__|__|                Pigs   |__|__|                 Poultry   |__|__|__|

     Have you sold or bartered any sheep, goats or pigs in the past 3                           0 = No
G4                                                                           1 = Yes
     months?                                                                                  (skip to F6)

G5   If yes, why?                                                  Reason |__|__|

G6   Have you sold or bartered any poultry in the past 3 months?             1 = Yes            2 = No

G7              If yes, why?                                       Reason |__|__|

                                                                                                2 = No
G8   Have you sold or bartered any cattle in the past 3 months?              1 = Yes
                                                                                              (skip to G)

G9   If yes, why?                                                  Reason |__|__|

                                           1 = No longer needed            2 = Pay daily expenses

                                           3 = Buy food for HH             4 = Pay medical expenses

                                           5 = other emergency             6 = Pay debt
     Codes for G5, G7 & G9
                                           7 =- Pay social event           8 = pay funeral

                                           9 = pay school costs            10 = other

                                           11 = No second reason




                                                    42
REFERENCES


Bureau of Statistics. 2003. 2001 Lesotho Demographic Survey: Analytical Report, Volume 1. Maseru,
        Lesotho.


BoS, 2002. Lesotho Core Welfare Indicators Questionnaire CWIQ Survey. Maseru, Lesotho.


Coady, D, Cgosh, M and Hoddinott, J. 2002. The targeting of transfers in developing countries: review
        of experience and lessons.


Dercon, S. 2001. Assessing vulnerability to poverty. Oxford University. Oxford, England.


Government of Lesotho. 2005. Guidelines for scaling up the fight against HIV/AIDS using local
        authorities in Lesotho. Maseru, Lesotho.


Greenblott, 2007. Social Protection in the Era of HIV and AIDS. Examining the Role of Food-Based
        Interventions. World Food Programme. Rome, Italy.


DMA-WFP, 2003. Lesotho Orphan Database, Draft Report on a Census Data. Maseru, Lesotho.


DMA-WFP, 2005. Community and Household Surveillance (CHS) Report : October 2005. Maseru,
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DMA-WFP, 2006. Uncovering Chronic, Persistent Vulnerability to hunger in the Southern
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CARE, 2001. Livelihoods in Lesotho. Maseru, Lesotho.


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FAO, 2007. Impact of HIV & AIDS on Rural Livelihoods. Phase 1 Report. Maseru, Lesotho.


Foster. G. (2005) Community Safety Nets for Children Affected by HIV/AIDS in Poor HHs in Sub
        Saharan Africa. Zimbabwe.


Foster. G. 2002. Understanding Community Response to Situation of Children Affected by Aids.
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Government of Lesotho, 2004. Poverty Reduction Strategy. Maseru, Lesotho.


Hunter, 1999. Building Systems of Protection for Children affected by HIV & AIDS in Lesotho.
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IASC, 2006. The need for HIV/AIDS Interventions in Emergency Settings. Inter-Agency Standing
        Committee. United Nations. New York, USA.




                                                 43
Kimaryo, S.S, Okpaku. J.O Sr, Gilhuku-Shongwe, A and Feeney, J. editors. 2004. Turning a crises into an
        opportunity: strategies for scaling up the national response to the HIV/AIDS pandemic
        in Lesotho. New York, USA.


Lesotho Red Cross Society, 2006. Smiling Once More: Integrated Community Home Based Orphan
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M. G. Makoae,2006. Knowledge Review and Gap Analysis Hunger and Vulnerability in Lesotho.


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Sechaba, 2000. Poverty and Livelihood in Lesotho: More than a Mapping Exercise. Maseru, Lesotho.


Reyes, C. M, Mandap, A. B, Ilarde, K, Garnace, L, Asirot, J and Bancolita, J. 2006. Community based
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UNAIDS, 2002. Children on the Brink. A Joint Report on Orphan Estimates and Program
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UNAIDS, 2005. UNGASS Country Report. Status of the National Response to the 2001 Declaration
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UNDP. 2004. Report on the proceedings of the national symposium on leadership for results:
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        pandemic. November 17 and 18. Maseru, Lesotho.


UNICEF. 2005a. The State of the World’s Children : Children under Threat. New York, USA.


UNICEF. 2005b. Guide to monitoring and evaluation of the national response for children
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World Bank, 2006. Social Protection – Safety Nets http://www.worldbank.org/sp/safetynets /Key
        concepts




                                                44

				
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