Protecting Children Affected by AIDS in Low Prevalence and Concentrated Epidemic

Settings: Development of Policy and ProgrammaticRecommendations for Greater Synergy with

Child Protection in South Asia

Table of Contents

Acknowledgements.......................................3List of Acronyms.......................................3

Executive Summary........................................3Introduction.............................................3Objectives of the research.............................3Research methodology...................................3Limitations............................................3

Issues Related to OVC and CABA in the SAARC Region.......3Protection, Care and Support Issues for CABA.............3International and Regional Commitments for Vulnerable Children.................................................3General commitments....................................3Commitments specific to HIV/AIDS.......................3

Country Specific Findings................................3India..................................................3Factors affecting OVC and CABA.........................3Responses and initiatives..............................3Child Protection Mechanisms............................3Social Protection......................................3Bangladesh.............................................3Factors affecting OVC and CABA.........................3Responses and initiatives..............................3Mechanisms for Child Protection........................3Legal and policy environment...........................3Social protection......................................3Nepal..................................................3Factors affecting OVC and CABA.........................3Child protection mechanisms............................3Social protection......................................3

Commonalities in Child Protection Programming Approaches across India, Bangladesh, and Nepal......................3Gaps and limitations...................................3

Conclusion...............................................3Recommendations for Addressing Needs of CABA in the Context of Reaching All Vulnerable Children..............3Immediate Actions for Policy and Programme...............3References...............................................3Annexes..................................................3Annex I: Research Plan.................................3Annex II: Interview Protocols..........................3

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Annex III: List of Key Informants in India, Bangladesh and Nepal..............................................3Annex IV: Commonalities in Child Protection Programming Approaches across India, Bangladesh, and Nepal.........3Annex V: Explanatory Notes.............................3

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List of Acronyms

ADB Asian Development Bank

AIDS Acquired Immunodeficiency Syndrome

APSSC Asia-Pacific Shared Service Centre

ART Antiretroviral Therapy

CABA Children Affected By AIDS

CARA Central Adoption Resource Agency

CEDAW Convention on the Elimination of Discrimination against Women

CRC Convention on the Rights of Child

DCWB District Child Welfare Board

DFID United Kingdom Department For International Development

DSS Directorate of Social Welfare

FPS Fair Price Shop

GDP Gross Domestic Product

GFATM The Global Fund for AIDS, TB and Malaria

HIV Human Immunodeficiency Virus

ICCPR International Covenant on Civil and Political Rights

ICDS Integrated Child Development Scheme

ICPS Integrated Child Protection Scheme

ILO International Labour Organisation

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JLICA Joint Learning Initiative on Children and AIDS

MDGs Millennium Development Goals

MWCSW Ministry of Women, Children and Social Welfare, Nepal

MWCD Ministry of Women and Child Development, India

NCLP National Child Labour Project

NGO Non-Governmental Organisation

NORAD Norwegian Agency for Development Cooperation

NPA National Plan of Action

NSAPR National Strategy for Accelerated PovertyReduction

OVC Orphans and Vulnerable Children

OPAC Optional Protocol on the involvement of children in Armed Conflict

OPSC Optional Protocol on the Sale of Children

PDS Public Distribution System

PMTCT Prevention form Mother to Child Transmission

RCC Rolling and Continuation Channel, GFATM

SAARC South Asian Association for Regional Cooperation

SIDA Swedish International Development Cooperation Agency

STI Sexually Transmitted Infection

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UNCRC United Nations Convention on the Rights ofChild

UNICEF ROSA United Nations Children's Fund Regional Office for South Asia

USAID United States Agency for International Development

VCT Voluntary Counselling and Testing

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Executive Summary

The HIV/AIDS pandemic has drastically changed the world inwhich children live. Millions of children have been infectedand died, and many more have been gravely affected by thespread of HIV through their families and communities. AIDS hasimpacted the daily lives of young people and increased thevulnerability and marginalization of children, especially thoseliving in difficult circumstances.

Limited attention has been paid to the care and protection oforphans and vulnerable children (OVC) as part of nationalresponses to HIV/AIDS in South Asia. There is a clear, and tosome extent acknowledged, “disconnect” between widely acceptedpolicies, principles and frameworks on the one hand, and actionon the other. Child protection and welfare has not been a highenough priority on the development agenda. National AIDSCommissions have been established, but their status, capacityand responses vary greatly. India, Bangladesh and Nepal havealso developed National Strategic Plans, but their qualityvaries significantly and they lack key planning components forthe operation, management and financing of the response.National AIDS Commissions in these three countries havegenerally struggled to coordinate the AIDS responseeffectively.

The United Nations Children's Fund Regional Office for SouthAsia (UNICEF ROSA) and the Asia-Pacific Shared Service Centre(APSSC), in partnership with Save the Children USA (SCUSA),commissioned this research study to generate evidence onsimilarities and differences in protection programmes for OVCand children affected by AIDS (CABA) as well as to identifygaps and weaknesses, with the aim of making programmaticrecommendations for policy consideration in South Asia. India,Bangladesh, and Nepal were selected for research due to thehigh burden of the HIV epidemic there, and the nature of thevarious vulnerabilities that children face, which may beapplicable to other South Asian countries.

The research methods for this assessment included key informantinterviews in the three countries and desk reviews of nationalpolicies, frameworks, and programmes. Analysis of factorsaffecting the vulnerability of children, responses andinitiatives of governments, child protection mechanisms, andsocial protection mechanisms led to several major findings.

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Policies, strategies and implementation plans for reachingchildren in need have made remarkable progress in the lastdecade. However, basic services like health, education,and social welfare are not reaching all vulnerablechildren, including CABA. Many children are unable toaccess these services because of a lack of coordinatedefforts by respective government departments, and thosewho are reached do not get quality services. In addition,there are few monitoring mechanisms in place to ensureeffective delivery.

Child protection, which is usually the responsibility ofministries of social welfare or women and childdevelopment, is generally an underfunded department withinsufficiently trained staff. Child protection requiresmultisectoral coordination and implementation involvinglegal, health, education and labour departments andministries. At the same time, dedicated funding for HIVhas resulted in the establishment of parallel structuresunder the national AIDS authorities. HIV-exclusiveprogramming tends to fragment existing structures and canresult in a lack of investment in general child protectionsystems.

Except in India, which has an integrated child protectionscheme, and Sri Lanka, which has a strong child protectionprogramme, countries of the South Asian Association forRegional Cooperation (SAARC) do not have specific policiesor plans for child protection. There is an immediate needfor SAARC countries to develop well defined childprotection systems in order to address issues such as weakcapacity, poor planning and coordination, lack ofinfrastructure, and insufficient human and financialresources.

HIV and AIDS specialists and child protection specialistsinterviewed for this study shared a common concern regardingthe need to develop sustainable institutional responses ratherthan having ad-hoc/project-led activities around childprotection. Both types of specialists are confident thatintegration is possible and would increase coherence. Theyagreed that HIV and AIDS in the family increases children’svulnerability and should be considered as a factor. Theyrecommended that governments develop national policies,strategies and action plans that address protection, care and

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support for CABA as a subgroup of all orphans and vulnerablechildren. There was a call to strengthen and build governmentalcapacity in ensuring protection of children, to developcomprehensive legislation to protect children, to establishstandards, guidelines and regulatory bodies to monitor andreview the quality of protection services, and to create bettersynergy with civil society programmes and services with goalsrelated to the protection of women and children.

The recommendations for addressing the needs of CABA within thecontext of reaching all vulnerable children are:

Operationalizing national action plans Strengthening systems Increasing investments in the social sector to improve

protection of OVC Developing the capacity of government staff Strengthening or developing new legislation and policies Strengthening data collection and use.

The immediate actions for policy and programme include: Analyse vulnerabilities of children in need. Define vulnerability more broadly in national action plans

for OVC. Promote cash transfers for poor and vulnerable households. Improve cross-referrals between non-governmental

organizations (NGOs), community and government socialservices.

Develop mechanisms for regional cooperation for datacollection.

Establish working groups with representation from allcountries in the region to monitor funding and establishaccountability measures.

Research new threats to child protection and integrate newknowledge into policy and programmes.

Increase investment by governments and donors in childrenand poverty reduction.

Combine social protection measures for mothers andchildren with comprehensive child protection programmes.

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Introduction

Asia, home to 60% of the world’s population, is second only tosub-Saharan Africa in the number of people living with HIV. In2008, 4.7 million [3.8 million–5.5 million] people in Asia wereliving with HIV, including 350 000 [270 000-410 000] who becamenewly infected last year. (India accounts for roughly half ofAsia’s HIV prevalence.) Asia’s epidemic peaked in the mid-1990s, and annual HIV incidence has subsequently declined bymore than half. Regionally, the epidemic has remained somewhatstable since 2000. In 2008, an estimated 330 000 [260 000-400000] AIDS-related deaths occurred in Asia; in South andSoutheast Asia the number was approximately 12% lower than themortality peak in 2004.1

Regional HIV/AIDS Statistics, 2001 and 2008

South and SoutheastAsia

Adults and children living with HIV

Adults and children newly infected with HIV

AdultPrevalence (%)

Adult and child deaths due to AIDS

2008 3.8 million(3.4 million–4.3 million)

280 000(240 000-320 000)

0.3 (0.2-0.3)

270 000(220 000-310 000)

2001 4.0 million(3.5 million–4.5 million)

310 000(270 000-350 000)

0.3(<0.3-0.4)

260 000(210 000-320 000)

Source: 2009 Epidemic Update, UNAIDS

The 2008 UNAIDS Global Report on the AIDS Epidemic estimated adult HIV prevalence among 15-49 year-olds in South Asia at 0.3%. In the SAARC region, an estimated 0.2% of 15-24 year-olds are living with HIV. Although this is a lower prevalence than in some other regions of the world, the size of the South Asian population means that the absolute numbers of young people withHIV are high. Moreover, a high proportion of the adult population living with HIV in the region has children. The impact of the epidemic is therefore felt not only by children with HIV but by children with infected parents. Moreover, within the fast-growing number of children at risk due to various causes, the subset of CABA is also on the rise.

In the absence of adequate surveillance systems to identify andtrack CABA in the SAARC region, a thorough assessment of theneeds of children and families affected by HIV/AIDS has yet tobe undertaken. However, it is clear that being affected by HIV

1 Update on AIDS Epidemic. UNAIDS, 2009.

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can cause children to be victimized and marginalized. It isexpected that in Asia HIV infection rates, among both adultsand children, will continue to rise over the next several yearsbefore stabilising, Economically, households are finding itincreasingly difficult to cope with the hardships associatedwith treatment costs and reduced income due to illness and lossin productivity.2

While HIV and AIDS affect children in all parts of the SAARCregion, the effects vary from country to country, depending ona variety of factors, including:

Epidemiological factors such as HIV prevalence Social factors such as risks and vulnerabilities among

certain populations Cultural factors such as childcare practices, orphan

uptake and care and the community’s resilience in dealingwith increasing numbers of vulnerable children

Socioeconomic factors including poverty levels andchildcare capacity3

The HIV epidemic in South Asia is occurring against a backdropof social exclusion and discriminatory practices, withextensive violations of children’s rights, above all the rightto protection. Failure to ensure this right adversely affectsall other rights of the child. Failure to protect children fromviolence in schools, child labour, harmful traditionalpractices, child marriage, child abuse, inadequate parentalcare and commercial sexual exploitation is also a failure tofulfilling constitutional and international commitments towardschildren. Without adequate collective action, the burden of OVCand CABA is likely to diminish development prospects, reduceschool enrolment and increase social inequity and instability.

This wider issue of the vulnerability of children and the lackof child protection deserves the specific and holisticattention of policy makers, decision makers and researchers,building on emerging evidence from regional studies on childpoverty and social protection. This report is intended as acontribution to these efforts.

2 Report of the Commission on AIDS in Asia, 2008.3 Protection and Care for Children faced with HIV and AIDS in East Asia and The Pacific: Issues, priorities, and responses in the region. Institute of Development Studies and UNICEF, 2008.

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Objectives of the research

The need for evidence based advocacy and programming for CABAwas identified as a key issue in the SAARC Regional Strategy onHIV and AIDS (2006-2010) resulting from the Twelfth SAARCSummit (Islamabad, January 2004) and its work plan endorsed atthe Twenty-Seventh Session of the Council of Ministers (Dhaka,August 2006). The Strategy articulates the need to “facilitateevidence based advocacy and programming for children affectedby HIV and AIDS in the Member Countries and to coordinate theefforts towards developing costed action plans in all countriesthrough the mechanism of a regional forum”. The RegionalConsultation on Children Affected by HIV/AIDS in South Asia(Kathmandu, May 2007) formulated a common approach for policyand programming, the SAARC Regional Strategic Framework for theProtection, Care and Support of Children Affected by HIV/AIDS.

The purpose of the present study is to accelerate evidence-based programming for CABA in the region by identifying ways tostrengthen and enhance child protection systems in general. Itis hoped that the review, analysis and recommendations of thisassessment will provide guidance for increasing the capacity ofchild protection systems to respond to children’s needs,whether due to HIV or any other difficult circumstances.

This report aims to enhance knowledge of the situation of allvulnerable children in South Asia, including those affected byHIV/AIDS, by describing existing care practices, programmes,and policies in this culturally and ethnically diverse region,and the extent of integration of child protection and nationalHIV/AIDS plans. The study describes commonalities anddifferences and identifies gaps and weaknesses. It proposesoperational recommendations for strengthening child protectionsystems to respond to the needs of all vulnerable children.

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Research methodology

Researchers took the following steps to conduct the assessment: Development of a Research Plan (Annex 1) based on the

Terms of Reference provided by UNICEF, and finalized inconsultation with UNICEF

Development of detailed activities and a timeline Development of interview protocols (Annex 2) for HIV/AIDS

and child protection programme managers in UNICEF and Savethe Children, and government officials.

Identification of agencies implementing care and supportprogrammes for OVC with support from Technical Support Hubof the India HIV/AIDS Alliance, UNICEF and Save theChildren Country offices in India, Bangladesh, and Nepal

Key informant interviews in India, Bangladesh, and Nepalto understand the programmes, policies on childprotection. (Travel plans to Bangladesh and Nepal werefinalized in consultation with UNICEF.)

All key informants were given a pre-interview briefing,and questionnaires were circulated to prepare them forinformation sharing and discussions.

The information provided by the key informants wasvalidated by reports and other sources of information, andthen synthesized for the study.

Relevant documents were collected from UNICEF, Save theChildren country offices, government departments and NGOsfor desk review.

Analysis of the information gathered through desk reviewand interviews

Limitations

The present study has certain limitations that must be borne inmind when considering its conclusions. Although it focuses onthen wide-ranging and very significant issue of childprotection, its limited geographic focus naturally restrictsthe extent to which its findings may be seen as generalizationsabout the situation in all of South Asia.

India, Bangladesh and Nepal were selected for this studybecause of the high burden of the HIV epidemic in thesecountries. It proved impractical to make field visits toPakistan, Sri Lanka and Afghanistan for logistical reasonsrelated to their political situations. Because of timeconstraints, the research methodologies were limited to desk

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review and interviews with key people in UNICEF, SCUSA,government officials and NGOs implementing programmes for CABAand OVC. It was hoped that this would produce a focused reviewproviding valid information on issues of CABA in a broaderchild protection context.

The conclusions as well as the limitations of this study mayalso indicate some interesting and potentially fruitful avenuesfor future research on child protection.

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Issues Related to OVC and CABA in the SAARC Region

All children can be rendered vulnerable to HIV by theparticular circumstances of their lives, especially:

Children who are themselves HIV-infected Children who have lost a parent, caregiver or teacher

and/or whose families or communities are severely strainedby the consequences of the disease

Children who live among populations most at risk of HIV

The vulnerability of children to HIV/AIDS results from acombination of political, economic, social, cultural and otherfactors. The consequences can entail having insufficientsupport to cope with the impact of the disease on theirfamilies and communities, being exposed to the risk ofinfection, subjected to inappropriate research, or deprived ofaccess to treatment, care and support if and when HIV infectionsets in.

Vulnerability to HIV/AIDS is most acute for children living inrefugee camps and camps for internally displaced persons, andchildren in detention or in institutions, as well as childrenliving in extreme poverty or situations of armed conflict,child soldiers, economically and sexually exploited children,and disabled, migrant, minority, indigenous, and streetchildren. However, all children have the potential to berendered vulnerable by the particular circumstances of theirlives.

According to Home Truths: Facing Facts about Children, AIDS and Poverty(Joint Learning Initiative on Children and AIDS, 2009),children have been peripheral to the AIDS response. Focusinginterventions only on paediatric AIDS is an insufficientresponse because HIV-infected children of all ages can bedisplaced due to stigma and lack of support services.

Even in times of severe resource constraints, the rights ofvulnerable members of society must be protected, and manymeasures can be pursued with minimum resource implications.Reducing vulnerability to HIV/AIDS requires first and foremostthat children, their families and communities be empowered tomake informed choices about decisions, practices or policiesaffecting them in relation to HIV/AIDS.

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The SAARC region’s response to the HIV/AIDS epidemic has gainedmomentum in the last fifteen years. Though all countries in theSAARC region ratified the UNCRC in the early 1990s, initialresponses to HIV/AIDS paid only cursory attention to the rightsof children, and rights-based approaches to programming forchildren began to emerge only in the last decade.

From the beginning, HIV/AIDS was categorized as a medical andhealth problem. This led to the mobilization of all resourcesfor treatment, biomedical purposes, surveillance and behaviourmodification strategies, rather than considering thesocioeconomic context of the epidemic. Although in recent yearssome organizations have paid attention to this aspect, verylittle has been done to empower communities and individuals toadapt safe practices within the realities of theirsocioeconomic context. Even today, strategic frameworks andnational action plans for HIV and AIDS are located withinhealth departments.

Protection systems and services for children have developedonly slowly in the region. While education, HIV and AIDS andother health issues have gained impetus from many global andcorporate commitments, a systemic response to rights protectionis only just beginning to emerge. Decision makers and policyplanners are struggling to create comprehensive legislative andprotective frameworks, and great efforts are required if theseare to result in concrete programmatic actions.

In the three countries analysed for this report—Bangladesh,India and Nepal— policies, strategies and implementation plansfor reaching children in need have made remarkable progress inthe last decade. Nevertheless, budgetary allocations forcomprehensive protection services for vulnerable children areas low as 0.3%,4 and funding for care and support programmesfor OVC is inadequate. As a result, basic services such ashealth, education, and social welfare are still not reachingall vulnerable children, including CABA, and those children whoare reached do not get high-quality services. This is due alsoto lack of coordinated effort by the relevant governmentdepartments, as well as inadequate monitoring mechanisms toensure effective delivery.

4 National Budgets of India and Nepal, 2006-8.

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Protection, Care and Support Issues for CABA

Because HIV/AIDS is often a fatal disease, particularly indeveloping countries, the probability that an affected childwill lose a parent—or even both parents in a relatively shortperiod of time—is high. Such children are especially vulnerableto economic hardship, which may lead to withdrawal from school,loss of home, loss of inheritance, and malnutrition andillness. HIV/AIDS places tremendous pressure on single parents,extended families and the traditional resources of communities.Government social safety nets are often absent, and even wherethey exist, they may fail to support the most marginalizedfamilies and communities.

In the absence of extended families or other community memberswho can take them in, children who lose their home are forcedinto institutions or onto the street. Institutionalization,while nominally more stable than life on the streets,nevertheless may expose children to further vulnerabilities:

Discrimination in access to services including health,education, and birth registration

Violence by caregivers and enforcement authorities,including police and the staff of in non-governmental orgovernmental institution.

Inadequate priority given to the needs of physically andmentally challenged children

Lack of recognition and identity, especially for OVC andmigrants

Less tangible but equally significant vulnerabilities for allOVC and CABA are lack of love, attention and affection,psychological distress, sexual abuse and the risk of HIVinfection, and stigma, discrimination and isolation.5

Further issues that need to be considered in developing careand support for OVC and CABA include:

The need for access to social benefits such as rationcards, houses for child-headed families, and freeeducation

The need for special attention to children of vulnerablegroups, such as sex workers and children rescued fromtrafficking, in accessing services

5 National Consultation on Children Affected by or Vulnerable to HIV/AIDS. UNICEF, 2006.

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Lack of monitoring to improve interventions—interventionsbased on poor data can negatively impact children’s lives

Lack of recognition of the vulnerability of children atrisk (such as street children, child labour and traffickedchildren) to health hazards such as HIV/AIDS, othersexually transmitted infections, reproductive tractinfections, and drug addiction.

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International and Regional Commitments for Vulnerable Children

General commitments

Children’s rights and welfare concerns have been addressed in anumber of international conventions and standards on childprotection, including the UN Convention of the Rights of theChild 1989 (UNCRC), the UN Standard Minimum Rules for theAdministration of Juvenile Justice 1985 (The Beijing Rules),the UN Rules for the Protection of Juveniles Deprived of theirLiberty 1990, the Hague Convention on Inter-country Adoption1993, the Optional Protocol on the Involvement of Children inArmed Conflict 2000 (OPAC), and the Optional Protocol on theSale of Children, Child Prostitution and Child Pornography 2000(OPSC). The UNCRC outlines the fundamental rights of children,including the right to be protected from economic exploitationand harmful work, from all forms of sexual exploitation andabuse, and from physical or mental violence, as well asensuring that children are not separated from their familyagainst their will. It emphasizes social reintegration of childvictims, without resorting to judicial proceedings. The guidingprinciples of the UNCRC are intended to influence the way eachright is fulfilled and monitored for progress. These principlesare:

The best interest of the child Non–discrimination The right to life, survival and development Respect for the view of the child.6

The treaty body is the Committee on the Rights of the Child.Each signatory state has to submit periodic reports to theCommittee. (This is applicable to the main treaty and theoptional protocols.) NGOs and civil society organizations maysubmit alternative reports. India, Bangladesh and Nepalratified the UNCRC in 1990-1993.

6 United Nations Convention on the Rights of the Child, 1989.

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Definitions of the Child

United Nations Convention on the Rights of the Child (UNCRC) Article1: A child means every human being below the age of 18 years.

Nepal: A child means every human being below 16 years of age. Thereis no uniform definition of child in the laws and policies of Nepal.

India: Though legislation has been enacted to make 18 years thegeneral age of majority in India, 21 years continues to be the upperlimit for childhood for some purposes, partly due to the influence ofnineteenth-century English law, and India recognises 21 years as theage of majority in circumstances where a guardian has been appointedby the Court for a child below the age of 18 years.

Bangladesh: There is no uniform definition of the child in the lawsand policies of Bangladesh, and understandings and legal provisionsvary according to civil law, the Convention, and sharia, as reflectedin the conflicting legal minimum ages of children for marriage.

The Committee on the Rights of the Child recommends the definition ofthe child be any person below 18 years of age, in accordance withArticle 1 of the Convention. It also recommends empowering the newlyestablished Committee to expedite its review of the variouslegislations and policies on the definition of the child, includingfor marriage, in the 1974 Children’s Act, the Penal Code, theChildren’s Policy and NPA to ensure that the State party can take aclear position to define the child in compliance with the Convention.

The UN Convention for the Elimination of all forms ofDiscrimination against Women 1979 (CEDAW) is significant forprotecting the rights of girl children. The InternationalLabour Organization (ILO) Minimum Age Convention 1973 (No. 138)specifies minimum age requirements in various forms of labour.The ILO Worst Forms of Child Labour Convention 1999 (No. 182)is a powerful document that can be invoked to eliminate theworst forms of child labour.

An important reporting mechanism that is relevant to Nepal isSecurity Council resolution 1612, which established a reportingmechanism on children affected by armed conflict. It monitorsand reports on:

Killing and maiming of children Recruiting or using child soldiers Attacks against schools and hospitals Rape and other grave sexual violence against children Abduction of children

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Denial of humanitarian access for children

To fulfil the rights of children and give them the bestpossible start in life, many governments must step up theirlevels of investment in basic social services. This wasrecognized at the 1995 World Summit for Social Development inCopenhagen, when governments agreed to the “20/20” compact.This called for an allocation of at least 20% of developingcountry budgets, and at least 20% of official developmentassistance, to basic social services. Most investment inchildren will come from national resources, but developingcountries, and especially the least developed countries, willrely on support from the international community7.

Commitments specific to HIV/AIDS

The General Comments of the Committee on the Rights of theChild on HIV/AIDS, issued in 2003, outline how the UNCRCprinciples apply to the States parties in the national responseto CABA. Special attention must be given to children orphanedby AIDS and to children from affected families, includingchild-headed households, as these situations impact theirvulnerability to HIV infection. The stigmatization and socialisolation experienced by children from families affected byHIV/AIDS may be accentuated by the neglect or violation oftheir rights, in particular when this discrimination results ina decrease or loss of access to education, health and socialservices. The Committee underlines the necessity of providinglegal, economic and social protection to affected children toensure their access to education, inheritance, shelter andhealth and social services, as well as to make them feel securein disclosing their HIV status and that of their family memberswhen the children deem it appropriate. In this respect, Statesparties are reminded that these measures are critical to therealization of the rights of children and to giving them theskills and support necessary to reduce their vulnerability andrisk of becoming infected.8The International Covenant on Civiland Political Rights 1966 (ICCPR) is not a child-focuseddocument, but Article 24 states that States should provide7 http://www.unicef.org/worldfitforchildren/files/A-RES-S27-2E.pdf retrieved on 20.01.2010

8HIV/AIDS and the Rights of the Child. Committee on the Rights of the Child, General Comment No. 3, 2003.

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“such measures of protection as are required by the child’sstatus as a minor”. The Human Rights Committee’s GeneralComment No. 17 says, “The rights provided for in Article 24 arenot the only ones that the Covenant recognizes for children andthat, as individuals, children benefit from all of the civilrights enunciated in the Covenant”.

The Millennium Development Goals (MDGs) adopted by 189 nationsand signed by 147 heads of state and governments in September2000 commit signatories to “halt and begin to reverse thespread of HIV/AIDS” (MDG Target 7).

The United Nations General Assembly Special Session on HIV/AIDSadopted a Declaration of Commitment in June 2001 which bindsmembers—including SAARC member states—by 2005 to “build andstrengthen governmental, family, and community capacities toprovide a supportive environment for orphans and girls and boysinfected and affected by HIV/AIDS, including by providingappropriate counselling and psychosocial support; ensuringtheir enrolment in school and access to shelter, goodnutrition, health and social services on an equal basis withother children; to protect orphans and vulnerable children fromall forms of abuse, violence, exploitation, discrimination,trafficking and loss of inheritance.”

In May 2002, the United Nations General Assembly SpecialSession on Children reiterated the importance of developingnational strategies, ensuring non-discrimination, mobilizingresources and building international cooperation. Based onthis, a strategic framework was developed to provideoperational guidelines for protection, care and support oforphans and children made vulnerable by HIV and AIDS. The fivestrategies are:

Strengthening the capacity of families to protect and carefor orphans and other children made vulnerable by HIV andAIDS

Mobilizing and strengthening community-based responses Ensuring access to essential services for OVC Ensuring that governments protect the most vulnerable

children Raising awareness to create a supportive environment for

CABA

The SAARC Regional Strategic Framework for the Protection, Careand Support of Children Affected by HIV/AIDS places CABA withinthe broader group of children in difficult circumstances, and

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focuses on delivering an integrated response to children’smedical, nutritional, educational, legal and psychosocialneeds, in line with the UNCRC. It calls for a universalapproach to ensure that CABA have access to the same public andsocial support systems which are available to other children,rather than being separated or singled out among their peers.This is linked to measures to address the stigma attached toHIV/AIDS, and to intervene on behalf of children who arediscriminated against as a result of this stigma.

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Country Specific Findings

India

There are 2.47 million persons in India living with HIV,9

equivalent to approximately 0.36% of the adult population. Outof these, 38% are women and 3.8% are children. More than onethird of the country’s population, around 440 million, is below18 years of age, and more than a million children under 15 havelost one or both parents to AIDS. Given the huge number ofchildren in India living with HIV-positive parents, and thelikelihood of their being orphaned at some point, thedifficulty in meeting the needs of these children is set toincrease,10 and community institutions will come underincreasing pressure.

The epidemic continues to inflict significant damage onaffected households, with particularly harmful effects on womenand children. The financial burden associated with HIV for thepoorest households in India represents 82% of annual income,while the comparable burden for the wealthiest families isslightly more than 20%.11

Because the HIV/AIDS epidemic is not generalized in India, theglobal and particularly sub-Saharan African concept of OVC doesnot apply. After consultations, the Government of India’sNational AIDS Control Organisation (NACO) and UNICEF developedthe concept of Children Affected by AIDS (CABA), to apply tothe particular situation of India. A detailed policy and actionplan to address CABA has been developed.12

Factors affecting OVC and CABA

It is estimated that around 170 million or 40% of India’schildren are vulnerable to or experiencing difficultcircumstances.13 Children who are particularly vulnerableinclude those who are beggars; the children of prostitutes,9 Revised estimates, 200710 Integrated Child Protection Scheme 2006, Ministry of Women and Child Development, Government of India.11 Global Report on the AIDS Epidemic. UNAIDS, 2008.12 UNGASS India Report, 200813 What does Union Budget 2006-07 have for children? Haq Centre for Child Rights, New Delhi.

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victims of domestic violence, those affected by conflict andnatural disasters, and those affected by development-relateddisplacement and forced evictions. Other factors affectingchildren’s vulnerability include child labour, the highincidence of gender discrimination leading to female foeticideand infanticide, child marriage, and disinheritance of orphans,as well as the incidence of HIV and AIDS.

The HIV/AIDS epidemic is leading to rising numbers of CABA as well as more AIDS orphans. Given that HIV infection is mostly concentrated among at-risk population groups—including sex workers and injecting drug users—for whom there are limited or no child protection measures in place, CABA may end up trapped in the same situations of poverty and deprivation as their parents. The social, economic and psychological impacts of AIDSon children combine to increase their vulnerability to HIV infection, educational disadvantage, poverty, child labour, exploitation and unemployment. Street children are considered still more vulnerable than other vulnerable children because they live in an exposed environment without adequate parental or adult care.

Many CABA face stigma and discrimination at home (denial of access to basic amenities and property rights), in the community (social isolation and denial of community resources),at school (isolation, neglect and denial of access to education), and in healthcare services (denial of access to health care and breach of confidentiality).14

There is an increasing trend towards child-headed households, with children caring for infected parents and siblings. As parents or caregivers become ill, children have to take on greater responsibilities for income generation and food production. Sick parents’ loss of livelihood forces children toleave school, and often to find some form of employment to compensate for the loss of income.15

Evidence suggests that orphaned children are best cared forwithin families and communities. Although institutionalizedcare is generally recommended as the final resort when extended

14 The India HIV/AIDS Alliance, “A situational analysis of child headed households and community foster care in Tamil Nadu and Andhra Pradesh States, India, 200615 The India HIV/AIDS Alliance, “A situational analysis of child headed households and community foster care in Tamil Nadu and Andhra Pradesh States, India, 2006

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family or the community cannot care for the orphaned child, incommunities throughout India more orphaned children are beingplaced in institutions by their families, partly because thematerial standards there are seen as being of higher qualitythan the families themselves can provide. This increases thescale of the problem and consumes resources that could bebetter used to strengthen family and community capacities tocare for and support vulnerable children16.

Responses and initiatives

The Constitution of India recognizes the vulnerable position ofchildren and their right to protection. Article 15 guaranteesspecial attention to children through necessary and speciallaws and policies to safeguard their rights. The right toequality, protection of life and personal liberty and the rightagainst exploitation are enshrined in Articles 14, 15, 16, 17,21, 23 and 24. However, most child protection concerns remainunder-documented, and the absence of systematic and reliabledata on categories of children in need impacts planning andintervention. There is no figure available for many categoriesof children in need of care and protection.

The Government of India upgraded the Department of Women andChild Development to the level of a ministry in 2006. The roleof the Ministry of Women and Child Development (MWCD) nowincludes policy formulation, programme implementation,coordination with other sectors, child budgeting, datamanagement, training and capacity building, and reporting andmonitoring on status of children and their rights. Thisenhances the coordinating role of the ministry with all othersectors, and appropriate mechanisms need to be put in place forthis purpose.

An analysis of child budgeting conducted by the MWCD revealedthat total expenditure on children in 2005-2006 in health,education, development and protection amounted to only 3.86% ofthe Union (federal) budget, rising to 4.91% in 2006-2007.However, the share of resources for child protection was merelyone hundredth of this—0.034% in 2005-06—and it remained thesame in 2006-07.

16 Interview notes of key informants from Clinton Foundation, Family Health International, and The India HIV/AIDS Alliance in India.

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Year Total Union Budget (BE) (Million rupees)

Total Child Budget (BE) (Million rupees)

% share of Child Budget in Union Budget

2004-05 4 778 290.4 116 957.2 2.452005-06 5 143 438.2 198 410.1 3.862006-07 5 639 911.3 276 745.8 4.91

Source: GOI expenditure budget, 2004-06 (vols 1&2) and “What does UnionBudget 2006-07 Have for Children”, Haq Centre for Child Rights, New Delhi

The Integrated Child Protection Scheme (ICPS) is intended tocontribute significantly to the realization of the state’sresponsibility for efficiently and effectively protectingchildren. It is based on the cardinal principles of theprotection of child rights and the best interest of the child.The objectives of ICPS are to improve the well-being ofchildren in difficult circumstances, as well as to thereduction of vulnerabilities to situations and actions thatlead to abuse, neglect, exploitation, abandonment andseparation of children. Unfortunately, the scheme is heavilyunder-resourced to put in the structures, institutions andservices required to reach all children.17

Government, UN agencies, civil society organizations andinternational NGOs have developed programmes to addressexclusion and discrimination in terms of caste, religion andgeography and empower communities to gain better access toservices. National and state action plans for children are inplace, and there are efforts to promote convergence andintegration of juvenile justice issues with the socialprotection sector. The main strategies for the UNICEF CountryProgramme with the Government of India (2008-2012) include:

17 Integrated Child Protection Scheme 2006, Ministry of Women and Child Development, Government of India.

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Establishment of state- and district-level childprotection units to address children’s vulnerabilities,violence and risk

Increased capacity of state functionaries and caregiversto protect and rehabilitate children in vulnerablesituations

Partnering with children’s organizations

A large number of international stakeholders and local NGOs areworking in India on issues of HIV/AIDS prevention, care andsupport, and treatment for CABA. Programmes offer informaleducational activities, linkages to mainstream education,nutritional support, community-based care and support,psychosocial support and counselling services, peer education,stigma reduction, and community mobilization. A key principleof these diverse programmes and organizations is to integratethis work into existing community programmes and activities toenable communities, and children in particular, to developownership.18

Child Protection Mechanisms

The existing institutions and programmes for child protectionin India stem primarily from the provisions under the JuvenileJustice (Care and Protection of Children) Act 2000, and theNational Plan of Action for Children 2005. These compriseseveral programmes and schemes implemented by differentministries and departments, including:

Programme for Juvenile Justice for children in need ofcare and protection and children in conflict with law. TheGovernment of India provides financial assistance to theState Governments/Union Territory Administrations for theestablishment and maintenance of homes, staff salaries,food and clothing for children in need of care andprotection and juveniles in conflict with the law.Financial assistance is based on proposals submitted byStates on a 50:50 cost-sharing basis.

Integrated Programme for Street Children without homes andfamily ties. Under the scheme NGOs are supported to run24-hour shelters and provide food, clothing, shelter, non-formal education, recreation, counselling, guidance and

18 Interview notes of key informants from Clinton Foundation, Family Health International, and The India HIV/AIDS Alliance in India.

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referral services for children. The other components ofthe scheme include enrolment in schools, vocationaltraining, occupational placement, mobilizing preventivehealth services and reducing the incidence of drug andsubstance abuse, and HIV/AIDS.

CHILDLINE Service for children in distress, especiallychildren in need of care and protection, to rescue themfrom abuse, provide shelter, medical services, counseling,repatriation and rehabilitation.

Scheme for Assistance to Homes for Children to promote In-Country Adoption for care and protection of orphans,abandoned or destitute infants or children up to 6 yearsand to promote their in-country adoption.

Scheme for Working Children in Need of Care and Protectionfor children kept as domestic child labour, working atroadside dhabas (restaurants) and mechanic shops. Thescheme provides for bridge education and vocationaltraining, medicine, food, recreation, sports equipment,etc.

Rajiv Gandhi National Crèche Scheme for the Children ofWorking Mothers in the age group of 0-6 years. The schemeprovides for comprehensive day care services, includingfood, shelter, medical services and recreation

Pilot Project to Combat the Trafficking of Women andChildren for Commercial Sexual Exploitation in source anddestination areas for providing care and protection totrafficked and sexually abused women and children.Components of the scheme include networking with lawenforcement agencies, rescue operations, temporary shelterfor the victims, repatriation to hometown, and legalservices.

Central Adoption Resource Agency (CARA) is an autonomousbody under the MWCD to promote in-country adoption andregulate inter-country adoption. CARA also helps bothIndian and foreign agencies involved in adoption of Indianchildren to function within a regulated framework, so thatsuch children are adopted legally through recognizedagencies and no exploitation takes place.

National Child Labour Project (NCLP) for rehabilitation ofchild labourers. Under the scheme, project societies atthe district level are fully funded to open up specialschools/rehabilitation centres for the rehabilitation ofchild labourers. These institutions provide non-formaleducation, vocational training, supplementary nutritionand stipends to children withdrawn from employment.

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Compared to other SAARC countries, legal activism is welladvanced in India. However, the judicial structure iscumbersome and unwieldy, leading to delays in remedial supportto children. The community structures and institutions andfrontline functionaries have little awareness about the rightsand procedures for safeguarding inheritance. In most Indianfamilies, succession planning is not a normative practice.

Social Protection

In the absence of an official definition of social protectionin India, it may be broadly defined as measures aimed atreducing poverty, vulnerability and social inequalities. TheConstitution of India includes articles that seek to protectwomen and children and improve the welfare of the family.19 Awide range of measures have been attempted in India over theyears to reduce risk and vulnerability and bring about apermanent improvement in the quality of life of poor andmarginalized sections of the population.

The Asian Development Bank (ADB) estimates social protectionexpenditures as 4.0% of GDP. Cash transfers or grants areavailable for girl children, the disabled, the elderly andwidows; however, the amount disbursed is meagre and cannotsustain individuals. The most interesting and often discussedsocial protection programme currently operating is the NationalRural Employment Scheme, which guarantees 100 days ofemployment to all poor families.

The Integrated Child Development Services (ICDS) is a nutritionand child welfare scheme aimed at children up to the age ofsix. The package of services provided under this schemeincludes health education for mothers, growth monitoring,immunization, supplementary feeding for undernourishedchildren, health check-ups, referral of sick children to healthcentres or hospitals, and early childhood education. The ICDSis the most important child protection scheme attempted inIndia and probably the largest childcare programme in theworld. It was initiated in 1975 following the adoption of theNational Policy for Children. Another nutrition scheme is themid-day meal scheme for children attending primary school,which was very successful in many states20.19 Social Protection for Women , Children, and Families: An Indian Experience by K.E. Vaidyanathan, 2006.20 http://wcd.nic.in/icds.htm retrieved on 20.01.2010.

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India has one of the world’s largest food security programmes,the public distribution system (PDS), which ensures supply ofessential food items at a subsidized rate. The system evolvedas a major instrument of the government’s economic policy forensuring availability of food grains to the public ataffordable prices as well as for enhancing food security forthe poor. It is an important constituent of the strategy forpoverty eradication and is intended to serve as a safety netfor the poor whose number is more than 330 million and who arenutritionally at risk.   PDS is operated under the joint responsibility of the centraland state governments. The central government hasresponsibility for procurement, storage, transportation andbulk allocation of food grains. The responsibility fordistributing them to the consumers through the network of FPSrests with the state governments. The operationalresponsibilities, including allocation within the state,identification of families below the poverty line, issue ofration cards, and supervision and monitoring of the FPS, alsorest with the state governments. With a network of about 500000 Fair Price Shops (FPS), PDS is perhaps the largestdistribution network of its type in the world. However, the PDSis plagued by corruption, pilfering and poor quality grainsthat at times are not fit for consumption21.        

These social protection programmes do not make specificprovision for reaching OVC, as they are intended to cover allfamilies in need. However, it is worth noting that ration cards(government-issued identity cards that list the profile ofmembers of each household) are not issued to child-headedhouseholds, which makes it difficult for double orphans toaccess the system.

Bangladesh

The first HIV/AIDS case in Bangladesh was reported in 1989.Since 1994, HIV infection levels have increased, although theproblem is still relatively small-scale, with around 12 000infected adults—0.2% of the total population. No data are yetavailable on the number of children living with HIV, and veryfew children are known to have been orphaned by AIDS in

21 http://fcamin.nic.in retrieved on 20.01.10.

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Bangladesh. UNICEF reports that the experience of orphanedchildren in Bangladesh, whether orphaned by AIDS or any othercause, is very difficult.22

Currently HIV is mainly confined to high-risk groups such asinjecting drug users, migrant workers and men who have sex withmen, and it is reported that this has led to a lack of urgencyamong policy makers in addressing the problem. However, it isthought that Bangladesh may gradually be heading towards anepidemic, unless a more effective response is developed. TheGovernment of Bangladesh adopted a National Policy on HIV/AIDSin 1996, and a multi-sectoral National Strategic Plan forSTD/HIV/AIDS for 2004-2010. A National AIDS Committee, withrepresentation from key ministries, NGOs and parliament,coordinates implementation of the Strategic Plan.23

Factors affecting OVC and CABA

Children in Bangladesh are affected more directly by poverty,floods, and cyclones than by HIV/AIDS. The country is prone tofrequent natural disasters which can lead to the separation anddisplacement of children. Those who lose their parents oftenend up as labourers or trafficked and cross-border traffickingis a major problem.

The National Household Income and Expenditure Survey conductedin 2005 found that about 40% of Bangladeshi households werepoor, and more than one quarter were extremely poor, with evenhigher rates among the country’s 63 million children. In 2007-2008, two major floods, a cyclone and high food pricesexacerbated poverty and insecurity for many people. Manychildren lost their parents and were displaced.

The immediate factors influencing children’s rights toprotection include:

Social acceptance of physical punishment of children The levels of personal stress and social or family-related

pressures experienced by caregivers The practices of child marriage and dowry Social acceptance of child labour The extent to which laws and policies on child protection

remain unenforced22 Situation Assessment and Analysis of Children and Women in Bangladesh. UNICEF, 2009.23 Government of Bangladesh – UNICEF Country Programme 2006-10, Mid-Term Review.

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The key areas where children’s right to protection ischallenged are abuse, exploitation, and lack of a comprehensivesystem for protecting the rights of children without parentalcare. The National Child Labour Survey estimated that about 1.3million children were engaged in hazardous labour. The worstforms of child labour in Bangladesh include domestic work,commercial sexual exploitation, waste picking, and rickshawpulling. Child domestic workers face restrictions on theirmobility and freedom of association. Living at their employer’sresidence, they are far from their own families andcommunities, have no external protection and are highlyvulnerable to sexual abuse. Many children are also drawn intocommercial sexual exploitation, sometimes when they are stillwell below the age of puberty. Some of these children are basedin large registered brothels, which are scattered throughoutthe country.24

According to a study by the Bangladeshi government and theBangladesh Institute of Development Studies, Bangladesh hadabout 674 000 street children in 2005, and Dhaka alone had 250000. Nearly half of these children were below 10 years of age,and nearly 80 percent were boys. Some of them are separatedfrom their families and have no one to care for them. Some haveparents who also live on the street, and some work on thestreet but live with their families in slum areas. Streetchildren are especially vulnerable to violence, sexual abuse,hazardous work, conflict with the law, and trafficking.25

Responses and initiatives

The Government of Bangladesh established the National Councilfor Women and Child Development in February 2009 as anoversight mechanism to address children’s issues. The Ministryof Social Welfare and its Directorate of Social Services (DSS)are responsible for identifying and supporting sociallydisadvantaged and at-risk people, including children. Theirstrength lies in their comprehensive network of social workersat the union level. However, they are constrained by limitedmanagerial and technical capacity, and limited financial andhuman resources. Planning and resource allocation follow a top-down approach, and activities focus strongly oninstitutionalization, and little attention is given to24 ILO-IPEC 2007, Bangladesh Child Labour Data, Country Brief.25 Situation Assessment and Analysis of Children and Women in Bangladesh, UNICEF, 2009.

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preventive measures or reintegration and rehabilitation ofchildren at risk. DSS implements a large number of programmesand has separate management structures, many of which haveoverlapping mandates or target groups.

The number of children residing in government, private, and NGOinstitutions has been estimated at about 50 000, but the actualnumber is probably higher. Government-run facilities wherechildren reside include orphanages, vagrant homes, juveniledetention facilities and adult prisons. The government also hassome “safe homes” and three centres for disabled children.Bangladesh has many madarsas that house and educate orphans aswell as children whose parents enroll them. NGOs and privateorganizations also operate some orphanages and shelter homesfor repatriated trafficking victims and children in conflictwith law.26

The government has 84 orphanages in locations around thecountry; housing approximately 9200 children aged 6-18 years.These are called Shishu Paribar, which means “children’sfamilies”. Orphans under the age of 6 years are housed in “babyhomes”. Bangladesh has three baby homes providing care forabout 225 infants and young children. The term orphan inBangladesh does not necessarily imply that both parents aredead or of unknown whereabouts. In fact, for a child to enteran orphanage, an adult must apply on his or her behalf. Thissystem closes the doors of the Shishu Paribar to many childrenwithout parental care. Many of these institutions suffer frompoor infrastructure, lack of regulation, vacant posts,untrained staff, and poor quality of care. There is a lack oftraining for staff on the deinstitutionalisation and placementof children in alternate care systems. DSS is developingminimum standards of care to replace the inadequate rules andregulations in order to strengthen the institutions.

UNICEF is supporting the government in building the capacitiesof institutions and social workers, and is also planning towork with major NGOs in Bangladesh to introduce case managementsystems. Through this system, children in drop-in centresreceive basic education, counselling, life-skills training andjob placement, as well as food and shelter. Family support andcommunity outreach activities encourage parents and communitymembers to interact with the children and help them readjust tolife in the general community. Simultaneously, UNICEF is also

26 www.msw.gov.bd retrieved on 10.12.2009

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focusing on capacity building of staff in the Women and ChildAffairs Department.27

Mechanisms for Child Protection

Bangladesh is home to about 63 million children.28 Bangladesh’spolicies, legislations and laws recognize the followingcategories of children as needing care and support:

Children without a home, and without any ostensible meansof subsistence

Children found begging, working or living on the streets Children endangered by a guardian or any other person with

whom s/he lives Mentally or physically challenged children Children suffering from a terminal or incurable disease;

having no one to support or look after. Accordingly,children living with HIV, as well those whose parents havedied due to AIDS-related illness and who do not havesupport are covered.

Children whose parents are unfit or incapacitated todischarge parental duties

Children abandoned or deserted by parents Children “missing” from homes and whose parents are not

traceable Children being or likely to be inducted in crime including

of a sexual nature Children vulnerable to and likely to be used in drug

related crimes Child being abused for “unconscionable gains” Children affected by war, terrorist attacks, civil riots

or other natural disasters such as earthquakes, floods anddrought

Child protection programmes in Bangladesh are integrated intosocial services and community development programmes, under theMinistry of Social Welfare and DSS. A number of child welfareagencies work for children’s rights and child protection. Withsupport from the government, bilateral donors and internationalorganizations, these agencies provide a range of services suchas community awareness raising, developing capacities ofcommunity members to manage protection issues, and managinglivelihood support programmes aimed at improving the economic

27 Key Informant Interviews with UNICEF, Bangladesh.28 Situation assessment and analysis of children and women in Bangladesh, UNICEF 2009.

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status of poor families.29 The government provides shelters anddrop-in centres for children living on the streets, sexuallyabused children, children engaged in hazardous labour, andchildren of commercial sex workers. These are managed andimplemented by the DSS.

UNICEF is piloting a community-based child protection programmefor children displaced by natural disasters, which providescash transfers to families who take care of these children. Theaim is to provide such children with a normal environmentwithin the community in which to grow and develop. Childrenorphaned or made vulnerable by Cyclone Sidr (2007) have beenfostered by relatives or other families in their localcommunities. The 2 000 foster families receive monthly cashtransfers of Taka 1 500 (US$ 22) for the children’s health andeducation needs. As the country enters the recovery andrehabilitation phase, social workers are helping familiesaccess social service facilities and livelihood and incomegeneration opportunities. UNICEF is also working with socialservices staff to ensure that the situation of individualorphaned children is closely monitored.

Currently, care and support for CABA is provided by networks ofself-help groups, which provide psychosocial support tochildren and ensure that they are placed in the communityitself. They are also responsible for providing anti-retroviraltherapy for people living with HIV, including children. Theprogramme supported through the Rolling Continuation Channel ofthe Global Fund for AIDS, TB and Malaria (GFATM), which willbegin in 2011, will focus on care and support for people livingwith HIV.

Legal and policy environment

The government has ratified the UNCRC, but little has been doneto protect vulnerable children. Child protection is a mandateof several departments and lacks the required coordination. Theapproach is project- or issue-based approach rather than tostrengthen systems. Departments for social welfare, women andchild affairs, health, education, and law, as well as NGOs,must work together to develop and implement a comprehensivepolicy to protect children in Bangladesh.

29 Key Informant Interviews with SCUSA, Bangladesh.

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UNICEF is helping the government to allocate a budget for childprotection.

The Children Act 1974 is not in line with the UNCRC, and mostdomestic laws conflict with the Convention. Although somechanges have been made to domestic legislation concerning birthregistration and citizenship, efforts at formulatingcomprehensive law remain weak.

A National Plan of Action (NPA) for 2005-2010 has been adopted,but implementation has been slow, since most of the relevantfunctionaries and departments remain unaware of it. Theimplementation guidelines are weak, and there are no monitoringand review mechanism in place to assess progress.

Although policies regarding children’s right to protection areweak in Bangladesh, the political will to bring about change isgrowing. The recent separation of the judiciary from theexecutive provides a long-awaited opportunity for legal reformin favour of children. The judiciary, and in particular thehigher judiciary, has become proactive in promoting andprotecting the rights of children in conflict with the law. TheSecond National Strategy for Accelerated Poverty Reduction(NSAPR II) acknowledges children’s right to protection fromabuse, exploitation, and violence. It places a priority on thesocial protection and education of street children, workingchildren, children who are refugees or internally displacedchildren in conflict with law, children in orphanages and otherinstitutions, children in sex work, disaster situations, brokenfamilies and urban slums. The NSAPR II also sets targets forreducing the prevalence of child marriage.30

The ability of the government to raise its own revenues toinvest in children is an area of concern. Donors and externalsources are responsible for 44% of the national budget, andmost interventions for children are conducted by civil societyand non-governmental agencies. Most investment for childrencomes from donors, especially the GFATM and NGOs. Moreresources are needed for OVC than for CABA because of the muchgreater number of OVC whose needs are not adequately met.

Social protection

30 Moving Ahead: National Strategy for Accelerated Poverty Reduction II (FY 2009-11), Bangladesh.

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Bangladesh has made remarkable progress in reducing povertysince the country’s independence in 1971. In 2002, 33% of thepopulation was reported to be living below the poverty line,down from an estimated 83% in 1971. This achievement is due tothe efforts of government, NGOs and the private sector inproviding employment opportunities as well as making financialcredit available to the poor.31 The principal goal ofBangladeshi economic policy has been to reduce poverty and thenumber of people living below the poverty line in the shortesttime span possible.

Total estimated social protection expenditure is 5.3% of GDPaccording to the ADB. Significant social protection programmesrelated to children include cash transfers for 5.2 million girlchildren in schools towards school fees, textbooks and learningmaterials; and a primary education stipend programme forfamilies whose children are in primary school. This comprises aconditional transfer of Taka 10032 for one child in primaryschool to Taka 125 for two or more children in school. A thirdprogramme is Cash for Education, a geographic and categoricaltargeting of poor families with less than 0.5 acresagricultural land, with a transfer of Taka 90 per month.33 Thereare also a number of employment guarantee social protectionprogrammes.

3131 Poverty Alleviation Human Resource Development and Ministry of Social Welfare, Bangladesh.32 1 Taka = 0.015 USD or 1 USD = 68 Taka,33 Poverty Alleviation Human Resource Development and Ministry of Social Welfare, Bangladesh.

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NepalNepal emerged from a long civil conflict in November 2006. Thenew federal government is confronting longstanding developmentchallenges at a time of global economic downturn.

UNAIDS estimates that HIV prevalence among 15- to 49-year-oldsis 0.5%, and approximately 70 000 Nepalese are living with HIV.Of these an estimated 2 000 are under the age of 15. There were4 900 deaths due to AIDS in 2008.34

Over a decade of civil conflict has increased the vulnerabilityof children in Nepal. The population under the age of 18totals about 1.2 million. Data indicate that 55% of thecountry’s population survives on US$ 1.25 per day. Theinternational definition of orphans is a limitation in Nepal.as two to three families live together35. Data on the number ofOVC are not available.

The current Children Act defines a child as any person belowthe age of 16 years. Upon turning 16, the child is entitled tomake legal transactions on property and is also eligible forcitizenship papers. The definition of child in the government’snew Children Act is compatible with the UNCRC’s definition.

Factors affecting OVC and CABA

The vulnerability of orphans and other children in Nepal isintensified by a number of factors, including poverty,discrimination related to gender and caste, family conflict,political instability, migration and displacement, recruitmentinto armed conflict, and HIV and AIDS.36 Vulnerability isfurther increased by traditional practices such as Chaibadi,37 as34 UNAIDS Epidemiological Fact Sheet on HIV and AIDS 2008, and AIDS Epidemic Update Dec 2009 by UNAIDS and WHO.35 Lakshmi Prasad Tripathi, Under Secretary, Ministry of Women, Children and Social Welfare, Government of Nepal.36 Sita Ghimire, Project Director, Save the Children Nepal.37 "Chhue, Chaibadi and Chueekula Pratha" are discriminatory practicesagainst women during their menstrual periods and the post-partum period in Nepal. Observational and open discussion studies were carried out in areas of the Mid- and Far-Western Regions of the country. These practices are

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well as untouchability, child marriage, child trafficking,child labour, children living on streets, child sexual abuseand sexual exploitation. Lack of proper reintegration andeducational and vocational opportunities could also exacerbatethe vulnerabilities of newly demobilized child soldiers.

Stigma and discrimination towards OVC due to HIV and AIDS putsthem at further risk of physical, emotional and economic abuse.As property prices increase rapidly, many cases have beenreported of families disowning orphans affected by HIV andAIDS. This is a risk that is faced by other children withinadequate parental care as well.

HIV/AIDS further intensifies the burden on socially excludedand marginalized children. Severe gender bias means that girlsare more likely to be forced to drop out of school to care forfamily and siblings. They also face higher risk of traffickingto India and Bangladesh, and an increased risk of sexualexploitation. Dalit girls are doubly disadvantaged compared todalit boys or non-dalit children.

The government has not allocated any resources specifically forchild protection. Women and child development officials haveresponsibility for protection issues of children, but they arealready overburdened with other responsibilities. A lack ofsocial workers severely constrains care and support programmesfor vulnerable children. This also reflects the absence of thebasic principle of the state as a guardian, leading to a lackof systems and structures that are empowered to take decisionsin the best interests of the child.

There is no legal and child protection expertise availablewithin District Administrative Committees to review each caseand advise on appropriate care plans for children. This lack ofcontinuum of care leads to increased vulnerability and risk oftrafficking, sexual, and economic exploitation of OVC. The mostviable and easy option available is to institutionalizechildren in orphanages. According to HIV and AIDS sector

continued through cultural norms, social taboos and superstition. During these periods, women are considered "impure” or “unclean" and are prohibited from takingpart in many normal aspects of their lives. These women believe that any breach in such practice will bring bad omens upon their family, community or society.

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specialists, this is also the more accepted approach for OVC astracking and administering ART to HIV-infected OVC is easier ininstitutions.

Rights violations faced by many children living ininstitutional care are widely reported. There is increased riskof sexual, physical, and emotional abuse. They live inovercrowded, poorly resourced premises. In the absence ofminimum standards of care and a regulatory body, it is achallenge to monitor and inspect these institutions.38

At the community, level paralegal committees have been formed;these groups are directed to address issues of domesticviolence. Recently the responsibilities of these committeeshave been expanded to address protection issues of children.However, their capacities are weak, and they need extensivetraining on child rights and protection framework in order tobe effective. By 2012, 1 300 Village Development Councils willbe covered by paralegal committees. The capacities of thesecommittees will be built to identify vulnerable children andrefer them to district-level committees.39

Child protection mechanisms

Nepal ratified the UNCRC in 1991. There is an increasingcommitment within Nepal to provide a protective and supportiveenvironment for OVC. This is evidenced by the setting-up of atechnical committee under the chairmanship of the Secretary ofWomen and Child Welfare to address issues related to childrenand HIV and AIDS. The HIV and AIDS strategy framework refers tocare and support programmes, and efforts are being made todevelop clear policy for care and support of OVC. For the firsttime, the National HIV and AIDS Action Plan 2008-2011 addressesissues of CABA. Although it lacks clear guidelines, it doesspecify that 20% of the entire HIV and AIDS resources should goto CABA.

Recently to broaden the mandate of technical group to includeissues of related to violations of protection rights, it hasbeen named as “children and AIDS”. This committee is debatingon issues separately for children below and above 14 years.

38 Bhanu Pathak, Child Protection Specialist, UNICEF Nepal.39 Annual child protection work plan 2009.

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Nepal has initiated the development of a National Action Planfor children which addresses risks to their well-being. ThePlan has contributed to the New Children Act 2009, whichreplaces the 1992 Child Act. (The draft was not available tothe researchers as the committee was still finalizing it.) Thecommittee was constituted under the chairmanship of theMinistry of Women, Children and Social Welfare (MWCSW); it hasmembers from other ministries, UNICEF, Save the Children, PlanInternational, Care and World Vision International. Thecommittee has a mandate to focus on:

Violence against children: abuse, neglect,discrimination and child marriage

Regulations and guidance on the New Children Act 2009 Child labour, sexual exploitation, abuse of children,

and trafficking CABA Children without adequate adult care in institutional

care Psychosocial distress Juvenile justice, juvenile courts, diversion, and

alternatives to custody Emergency services.

The Central Child Welfare Board under the Ministry of Women,Child Welfare and Social Affairs is a nodal department incharge of delivering all protection related services tochildren.40 In each district there is a District Child WelfareBoard (DCWB), which works with support of NGOs. Save theChildren supports DCWBs in 32 out of 75 districts, and PlanInternational in 12 districts, through human resources andcapacity development activities of local staff.

Alternative care and support interventions are virtuallynonexistent. Currently, with support from UNICEF, the Nepalesegovernment is drafting guidelines for adoption to prevent thesale and trafficking of babies.41

The Juvenile Justice Act of 2006 addresses issues related tochildren in conflict with the law. The age of criminalresponsibility is 10 years and children below cannot beproduced in court. However, capacities among enforcement andjudiciary on juvenile justice mechanism are low.

40 Lakshmi Prasad Tripathi, Under Secretary, Ministry of Women, Children and Social Welfare, Government of Nepal.41 UNICEF Annual Work Plan 2009.

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Social protection42

Total estimated social protection expenditure in Nepal is 2.3%of GDP. The Government of Nepal has a range of socialprotection programmes aimed at different categories ofvulnerable populations, but as is common with SAARC countriesthese are distributed across different ministries and agencies,and there are no common frameworks or standards to evaluateprogrammes for effectiveness.43

42 Discussions with Beth Verhey, Chief Social Policy and Decentralization and Thakur Dhakal, Programme Officer-Social Policy & Decentralisation.43 Social Protection In Nepal_ Introducing a Child Benefit: Unicef Nepal Concept Note June 2009 by Beth Verhey, Chief of Social Policy, Unicef Nepal

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Basic categories of social protection are:44

Food-based transfers: public distribution system, middaymeals and nutritional supplements for mothers and children

Cash transfers: pensions for elderly, poor widows andpeople with disabilities

Social welfare/care services for children, the elderly andpeople with disabilities

Employment protection measures including public worksprogrammes, labour protection and social security

Strategies to graduate out of vulnerability, includingtraining and vocational education and micro-credit foremployment opportunities and CCTs as opportunities forintergenerational capital accumulation

44 Social Protection in Nepal. Human Development Unit, South Asia Region, World Bank. June 10, 2009.

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Commonalities in Child Protection Programming Approaches across India, Bangladesh, and Nepal Commitments towards certain sectors such as health, educationand social protection in child protection have increased inIndia, Bangladesh and Nepal. Major bilateral and multilateralagencies such as the United Kingdom Department forInternational Development (DFID), the United States Agency forInternational Development (USAID), the Norwegian Agency forDevelopment Cooperation (NORAD), the Swedish InternationalDevelopment Cooperation Agency (SIDA) and the World Bank havefunded all three countries to address child labour, cross-border trafficking, and protection, care and support for CABA.

Voluntary counselling and testing (VCT), the prevention ofmother-to-child transmission (PMTCT) and the provision of ARThave always attracted donor funding. However, fundingallocations for CABA remain far below what is required forrobust care and support programmes, despite the fact that mostdonor agencies recognize the importance of such interventions.As the table below shows, donor funding far exceeds the budgetrequired in VCT, but there are 72.8% fewer resources forprogrammes related to children. Within HIV and AIDS funding forchildren, protection care and support programme receives muchless funding. Below table shows budgetary allocation forchildren in Nepal.

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Without legislative and policy frameworks, it is difficult toset realistic budgets for protection services. Child protectionusually falls under the ministries of social welfare andministries for women and children, which have been relativelyunderfunded, with inadequately trained staff. Current budgetoutlay for women and children is only 0.3% of the total budgetin India. In addition, child protection requires multisectoralcoordination and implementation, as it covers the legal,health, education and labour ministries.

On the other hand, dedicated funding for HIV has resulted insetting up of parallel structures under the national AIDSauthorities. Such structures have resulted in lack ofinvestment in building child protection systems and havefragmented existing structures with programming exclusive toHIV. Since governments alone cannot take care of issues relatedto child protection such as care and support at communitylevel, there is a need to reinforce investment in communitystrategies to care for children and keep them out ofinstitutions and off the streets.

Apart from India, which has an integrated child protectionscheme, and Sri Lanka, which has a strong child protectionprogramme, the rest of the SAARC countries do not have specificpolicies or plans for child protection. This assessment hasmade it clear that there is an immediate need for SAARCcountries to develop a well defined child protection system inorder to address issues such as weak capacity that result inpoor planning and coordination, lack of infrastructure toaddress the needs of OVC and CABA, and insufficient human andfinancial resources.

A protective environment framework for children has beendeveloped by UNICEF and serves as the basis for protectionprogramming for many child-focused agencies. It recognizesthree key concerns: exposure to violence/abuse/exploitation,deprivation of primary caregivers, and discrimination in accessto basic social services. The framework has the followingcomponents:

Effective policy and legal framework Effective regulating bodies or committees that are

empowered to take decisions to ensure that systems workeffectively

Plans to develop a cadre of child protection workforce;building capacities of all functionaries in child

46

protection; and laws and policies for coordinated andcoherent implementation

Strengthening coordination mechanism between protectionsystem, civil society responses and other relevant lineministries to ensure better access to basic essentialservices. Coordination mechanisms at lateral and verticallevels.

Preventive and responsive services to address needs of OVCand children in difficult circumstances

Strengthening of structures, institutions and processesfor service delivery

Strengthening of case management skills at community anddistrict levels. This would mean developing a strongsocial work system capable of responding to specific childprotection issues and cases.

Education of the public, families and communities on childprotection issues, to establish protection of children asa normative behaviour

Gaps and limitations

In a region that has cultural and social attitudesdiscriminating against people with HIV/AIDS, stigma anddiscrimination add to the social exclusion of adults andchildren living with the disease. There are major shortcomingsand gaps in implementation of programmes and policies at alllevels. The minimal government structure that does exist isrigid, and a lot of time and energy are spent on maintainingthe structure itself rather than concentrating on programmaticoutcomes. While strong advocacy and lobbying initiatives andglobal pressure have led to child-centric policies, these areseldom put into practice in the best interest of children, dueto a lack of focus and attention to community- and district-level operations.

47

In all three countries, programmes are marked by limitationsand gaps in a number of areas:

1. Policies for preventionPolicies, programmes, and structures to prevent children fromfalling into difficult circumstances are mostly lacking in twoareas:

Policies to strengthen and empower poor and vulnerablefamilies to cope with economic and social hardship andchallenges and thus be able to take care of their children

Efforts to raise awareness on child rights and childprotection

2. Planning and coordination Poor implementation of existing laws No mapping has been done of children in need of care and

protection or of the services available for them atdistrict and state levels.

Lack of coordination and convergence ofprogrammes/services

Lack of linkages with essential services for children,e.g. education, health, judiciary

Weak supervision and monitoring of the juvenile justicesystem

3. Services are negligible relative to the needs Most of the children in need of care and protection, as

well as their families, do not receive any support andservices.

Resources for child protection are meagre and unevenlyused.

Inadequate outreach and funding of existing programmesresults in marginal coverage even of children in extremelydifficult situations.

Ongoing large-scale rural-urban migration creates a greatnumber of varied problems related to social dislocation,lack of shelter, and abject poverty that are notaddressed.

Lack of services to address issues such as child marriage,female foeticide and discrimination against the girl child

Few interventions for CABA, drug abuse, militancy,disasters, abused and exploited children and children ofkey populations such as sex workers, prisoners, andmigrants

Few interventions for children with special needs,especially mentally challenged children

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4. Poor infrastructure Structures mandated by legislation are often inadequate Inefficient functioning of juvenile justice boards due to

lack of facilities to dispose of cases quickly

5. Inadequate human resources Lack of training and capacity building of personnel

working in the child protection system Large number of vacancies due to lack of budget and non-

availability of qualified staff Lack of competent, skilled personnel who understand issues

related to child protection, especially to providepsychosocial support

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6. Lack of accountability, monitoring and evaluation Data required for planning, policy making and monitoring

are not available. Monitoring and evaluation mechanisms are not in place;

reporting and accountability are not clearly defined orenforced in most programmes.

7. Lack of coordinated investments and resource allocation bydonors and national governments

The levels and nature of investment in children are notcommensurate with the existing needs. Both povertyreduction and human development must claim a larger shareof national investment and donor assistance.

Need to reorient the national governments and donors oninvestment planning towards successful outcomes of childprotection programmes.

Combining social protection measures for mothers andchildren with comprehensive child protection programmeshas transforming potential for orphans and vulnerablechildren.

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Conclusion

The protective framework (UNICEF 2007) recognises that familiesand children have an inherent resilience. However, with thecurrent downturn in the global economy and high rates ofinflation in many SAARC countries, this resilience is understrain. The government and civil society organizations have notbeen able to strengthen capacities of families and communitiesto protect, care for and support OVC.

Access for OVC to essential services such as education, health,nutrition, birth registration and other protection services islimited due to the poor quality of available services, under-resourcing, and the small scale of operations. In all threecountries there was evidence that the first resort for care andsupport is long-term institutional care as opposed to carewithin the children’s own communities, because extendedfamilies and communities are already financially stretched, andthere is a lack of support through cash transfers madeavailable to families and households affected by AIDS.

Foster care as an alternative is not well developed, and stateshave not established mechanisms to strengthen it. Few models offoster care supported by civil society and NGO groups areavailable. This option of care appears more in HIV and AIDSprogramming than in the general continuum of care. Communityawareness and mobilization on protection issues is notuniversal.

The bias among HIV and AIDS experts is towards institution-based care as this is more convenient for administering ART.Although a few interviewees implementing programmes for OVCsaid that they do not have capacities in child protection as asector, all recognized that protection issues require realisticsolutions that take into account the best interest of thechild. These implementing agencies must take steps to improveunderstanding about child protection and enhance their skillsand competencies. Similarly, child protection agencies mustimprove their understanding of the issues of OVC. There is nocomprehensive legislative and policy framework to establishprotection services, and south Asian cultural and social normsprivilege adults over children.

Very few NGOS and individuals have specialized knowledge orexperience in child protection programming and child rights. It

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was evident during the assessment that child protection isoften construed as social protection or as part of socialprotection or protecting the rights of children. Childprotection is often equated only with issues of child labourand street children, and the wide diversity of children’s needsis not articulated. In the SAARC region all cultures considerprotection of children to be a private issue. Stigma related toHIV or being labelled an orphan contributes to the abuses facedby children, increasing their vulnerability and risk of furtherexploitation. Fostering open discussion can help reduce HIV-related stigma, making these violations less hidden and lessacceptable.

Child protection as a whole has not piggybacked on high-profileinternational events. Child labour, trafficking, child sexualabuse and sexual exploitation and violence against childrenhave been researched as individual topics, and there is a bodyof evidence and data on these issues. However, there is a needfor additional data and evidence-based analysis andunderstanding on the policies and programmes needed for childprotection in South Asia as a whole. Because some of theseissues are highly stigmatized, political and administrativeleaders are unwilling to acknowledge problems. Taboos andsensitivities must be tackled but are unlikely to be diminishedquickly.

Failure to ensure children’s rights to protection adverselyaffects all other rights of the child. Thus, the MDGs cannot beachieved unless child protection is an integral part ofprogrammes, strategies and plans for the Goals. Failure toprotect children from issues such as violence in schools, childlabour, harmful traditional practices, child marriage, childabuse, the absence of parental care and commercial sexualexploitation among others, is a failure to fulfil bothconstitutional and international commitments towards children.

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Recommendations for Addressing Needs of CABA in the Context of Reaching All Vulnerable Children The assessment shows that though there are glaring gaps insystems for the protection, care and support of OVC, this isnot due so much to lack of political and administrative will asto problems in developing such systems. Positive steps thatcould help the region are:

Operationalizing National Plans of ActionThough NPAs have a clear set of goals and targets,translating them into reality seems difficult. One of themost important goals is therefore to give definitepriority to children and implement policies supported byall government ministries and agencies. There is a needfor a sustainable system to monitor expenditures onchildren: this requires transparency in the budgetingprocess as well as building the capacity of NGOs andchildren to advocate for greater investment for children.Budgeting should be recognized as a tool for measuringprogress and developed as an indicator to measurecommitment to children.

Strengthening systemsStrengthening systems to respond to vulnerable childrenposes significant political, administrative andprogramming challenges. The intricate linkages betweenprotection and other systems need to be well defined inorder to fulfil all protective functions. Ministries offinance and planning need to find effective ways toincrease the profile of child vulnerability issues and tomainstream social protection in poverty reduction plans.

Coordinated investment in the social sector to improveprotection of OVCInvestment should be directed towards increasing access tobasic services and providing social support and protectionfrom abuse and neglect. Social cash transfers can act as aprotective mechanism for recipient households in thecontext of poverty and rising food prices. It is importantto increase the capacity of families and communitiesthrough civil society partnership to care for vulnerablechildren and minimize the need for institutional care.

Capacity building of government staff

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Protection services require skilled, sensitive staff,equipped with knowledge of child rights and standards ofcare and protection. The capacities of staff in socialwelfare and women and child development ministries requirestrengthening on a continuous basis. This can be done bystrengthening training institutions, developing newtraining curricula and conducting trainings of trainers.Service providers should also be trained on providingprofessional counselling services to enable children torecover from adverse experiences, and to help build acaring and protective environment for them. In order toachieve this, strong financial and technical support isneeded.

Strengthen or develop new legislation and policiesIt is recommended that governments strengthen rights-basedlegislation for child protection, ensuring that childtrafficking; harmful labour and sexual abuse areexplicitly made illegal. National legislation shouldcodify laws related to child protection in sufficientdetail to be enforceable. Legal frameworks should reflectentitlements to appropriate services and recognise therights of OVC to equal protection and access. Civilsociety organizations should be involved in legal reformand enforcement efforts to ensure changes to legislationare widely disseminated and implemented.

Strengthening data collection and useQuantitative and qualitative data are essential toidentify OVC, understand trends and design comprehensiveprogrammes to address their needs. Improved knowledgeabout OVC can inform the development of strong nationalstrategies that are crucial to effective and continuedprotection, care and support.

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Immediate Actions for Policy and Programme Assistance to OVC continues to be carried out primarily byfamilies, faith-based groups and NGOs. Successful programmingreinforces the capacity of these support systems. Governmentshave an important role in coordinating these efforts. Immediateactions or policy and programme include:

Issues of children in need and their overlappingvulnerabilities should be analysed within specific countryand local contexts.

National Plans of Action for orphans and vulnerablechildren should have a broad definition of vulnerability,beyond orphanhood and vulnerability due to AIDS.

Promote cash transfers as a cost-effective approach to

assist poor and vulnerable households. Link cash transferswith social welfare services to increase their reach andeffectiveness.

Cross-referrals between NGOs, community and governmentsocial services are seldom undertaken. This is one clearway to expand coverage and capacity of both the sectors.

In view of the Regional Commitments and issues emergingfrom the SAARC conventions, mechanisms for regionalcooperation for data collection will have to be developedto strengthen collaborative efforts at child protection.

Working groups represented by all countries (governmental,protection and HIV and AIDS specialists from NGOs) shouldbe set up to map and track funding for the childprotection and social protection sectors. These groupsshould study aid effectiveness and establishaccountability measures.

Investigate and research areas of potential or new threatsto child protection to build knowledge and evidence, andintegrate them into policy and programmes such aslivelihood security, migration, internal displacement etc.This is essential for translating assumptions to evidencefor planning appropriate response and services andbuilding appropriate safeguards.

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The levels and nature of investment in children are notcommensurate with the existing needs. Both povertyreduction and human development must claim a larger shareof national investment and donor assistance, and nationalgovernments and donors must reorient their investmentplanning towards successful outcomes of child protectionprogrammes.

Combining social protection measures for mothers andchildren with comprehensive child protection programmeshas transforming potential for orphans and vulnerablechildren.

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13. FHI Quality Improvement Guidelines for Care and Support for Orphans and Other Vulnerable Children

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15. UNICEF Child Protection strategy; United Nations Economic and Social Council, May 2008.

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16. Common Cause, Collectives Strength: Findings of an evaluation of support groups of women and children living with and/or affected by HIV/AIDS in three Indian States, The India HIV/AIDS Alliance, 2006

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23. The Children ACT, 1974, A Critical Commentary, Shahdeen Mallick

24. Poverty Alleviation: Human Resource Development and Ministry of Social Welfare; Government of the People’s Republic of Bangladesh, Ministry of Social Welfare.

25. UNICEF Bangladesh Country Office HIV/AIDS strategy, August 20009

26. Children and HIV/AIDS in Bangladesh – Opportunities and potential role for Child Rights Organizations, Addullah Harun, Ananya Banerjee, Iqbal Hussain, Mahfuza Haq, Kajal Ahmed, Shumon Sengupta, Munir Ahmed

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AIDS/STD Programme; Directorate General of Health Services, Ministry of Health and Family Welfare

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32. National HIV and AIDS action plan 2008 – 2011, Government of Nepal HIV, AIDS, STI control board, March 2009

33. A situation assessment of children affected by AIDS in Nepal, CREHPA and Save the Children

34. Country programme action plan 2008 – 2010 between the government of Nepal and United Nations Children’s Fund

35. Improving Lives for Children and Women in Nepal, Decentralised action for children and Women (DACAW)

36. National HIV/AIDS Strategy (2006 -2011) Nepal, National Centre for AIDS and STD Control.

37. Concluding observations of the Committee on the Rights of the Child for Nepal's Second and Third Combined Periodic Report CRC 39: Nepal reporting to the Committee on the Rights of the Child 2005

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41. National Progress Report,” Plus 5" Review of the 2002 Special Session on Children and Women, UNICEF 2007

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42. A world Fit for Children Plan of Action

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46. Social Protection in Nepal; Human Development Unit ;South Asia region ; World Bank, June 10, 2009.

47. SAARC framework for protection, care, and support ofOrphans and Vulnerable Children living in a world with HIV/AIDS, 2009

48. Better Care Network’s publication of Alternate care in South Asia

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50. State of the World Children 2009, UNICEF

51. Achieving Universal Access – Biennial Review of UK’sApproach to Supporting the Needs and Rights of Orphans andVulnerable Children (DFID)

52. Children and AIDS – Third stocktaking report, UNICEF2008

53. Social Protection in South Asia: A Review, UNICEF

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55. Orphans and Other Vulnerable Children programming Guidance for US Government In staff and Implementing Partners

56. Enhanced Protection for, Children Affected by AIDS: A companion paper to, The Framework for the Protection, Care and Support of Orphans and Vulnerable Children Livingin a World with HIV and AIDS, UNICEF 2007

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61. Quality Programs for Orphans and Vulnerable Children: A Facilitator’s Guide to Establishing Service Standards DRAFT – June 1, 2007, prepared by Lori DiPrete Brown, MSPH Assistant Director, Center for Global Health University of Wisconsin Special Technical Coordinator, University Research Corporation., LLC Consultant, Pact Inc.

62. Monitoring the Declaration of Commitment on HIV and AIDS; Guidelines on Construction of Core Indicators: United Nations General Assembly Special Session on HIV andAIDS, Aug 2003.

63. The State of the World’s Children, Special Edition, Celebrating 20 years of the Convention on the Rights of the Child

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Annexes

Annex I: Research Plan

Purpose of ResearchThis research is to recommend strategies and approaches tostrengthen and enhance child protection systems that addressthe protection needs of children under difficult circumstances.

Geographical Span: India/ Nepal/ BangladeshWithin a time-frame of 30 days, team needs information on:

Current policies and programmes of each country Review/ evaluation/ impact assessment of UNICEF and

government programmes Vulnerabilities of children in each country:

discrimination/social exclusion, etc. Policies and plans of national governments: social

welfare/ health/protection/ education Areas of convergence in child protection and HIV and AIDS

(need to analyse how programmes are addressing stigma/discrimination)

Integration and mainstreaming of HIV and AIDS in child protection

Research Identify opportunities and challenges for meeting the

protection and care needs of all vulnerable children,including CABA.

Integration of HIV/AIDS into child protection programmeswith particular focus on HIV “vulnerability” in thecontext of SAARC framework, and propose programmaticrecommendations for consideration.

List and identify specific vulnerabilities that childrenwho are vulnerable to, and affected by AIDS face whichneed to be addressed by protection programmes forvulnerable children in general, and assess their relationto other highly vulnerable sub-populations of children.

Map sectors and players involved in child protection andCABA response, including public sector as well as civilsociety organizations

Draw similarities and distinctions between these two areasof programming, and anticipate challenges to overcome inorder to achieve integration and synergy for greaterimpact.

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Understand cost-benefit options where possible fordelivery of integrated child care and protection servicesto CABA and all vulnerable children.

Activities

In-depth information through interviews of key informantsto understand commitments and resources available toimplement coherent programmes.

In-depth interviews with government functionariesresponsible for implementation of policies and programmes,child protection specialists of UNICEF, Save the Children,and state and non-state actors working with children(NGOs).

Desk review of policies, frameworks, programmes, andresource allocation for programmes for OVC and CABA.

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MethodologyField visits to Bangladesh/Nepal/India

Consultants will meet and discuss with UNICEF/MWCWofficials to identify various services existing and listof child protection agencies. Set up time to interviewpreceded by email communication on the purpose ofinterview. Gather information and collect availablereports/documents. Visit similar service providers to getan idea of operations and systems with regard to OVC andCABA.

List agencies implementing care and support programmes,with support from Technical Support Hub, The IndiaHIV/AIDS Alliance to interview them

All interviewees will be given pre-interview briefing, andquestionnaires will be circulated to prepare intervieweefor information sharing and discussions.

Interviewees will be contacted for a telephone discussionto plug gaps or additional questions that arise duringdata analysis.

Desk Review

Undertake a detailed desk review of programmes that seekto address either broader child protection issuesincluding those of CABA or exclusively focus on CABA.

Desk review of policies/programmes that addresses childprotection issues of CABA and other OVC.

Review national response to CABA and other OVC to delivereffective services and support that prevent violation ofrights by researching policies/plans and budgetaryallocations in protection/education/social protectionsectors.

Mainstreaming and integration manuals and concept notes ofdifferent agencies in different sectors. (Also reviewmainstreaming tool kits in other sectors,)

The desk review and interviews will support consultants inplacing the research in the SAARC socio-political context.

Efficiency and quality of public and social care systems will be measured1) By assessing level of convergence of all services

a) What are the investments in care and protection?b) Are there any strategies in place for early intervention?

2) By identifying risks and challenges that hinder theintroduction of these.

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3) By analysis of all available policy documents on the subjectof children, procedures and guidance documents, annualreports of agencies involved in alternate care and supportprogrammes.

4) By collecting material from the ministry and relevantorganisations, and international protocols,

Review/ Compilation/Analysis of Data Develop format for collating information. Review the information collected. Identify gaps and try to access relevant information

through secondary sources or telephone interviews for all additional questions raised.

Compilation and Report WritingA preliminary draft will be completed by 25th November 2009 forinternal circulation and feedback. The draft report will besubmitted to UNICEF for comments and feedback by 5th December.Final report will be completed for internal scrutiny by 20th

December 2009.

Annex II: Interview Protocols

Schedule A: Child Protection Specialists (UNICEF/SCUS/INGOs/Bilateral Agencies)

1. Can you give us an overview of child protection issues inIndia/ Nepal/ Bangladesh?

2. Who are most vulnerable sub populations of children? Howdoes HIV/AIDS impact these groups?

3. What are the factors influencing vulnerability of children?

4. In your opinion what are four top social exclusion practicesin your country? What are the range of protection problemsfaced by CABA and OVC?

5. What are existing care practices/programs and policies forvulnerable children available?

6. How do these policies/legal instruments support or hinder inaddressing the needs of vulnerable children including thoseaffected by HIV and AIDS

7. What are the existing policies for CABA? Do they focus on

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child protection?

8. Are there any strategic plans/documents in place with theorganizations working on child protection?

9. Government commitment towards child protection in terms ofprogrammes, policies and budget allocation?

10. What in your opinion are differences or similaritiesbetween child protection and HIV/AIDS programming

11. What are challenges to achieve integration and synergy ofHIV/AIDS and child protection programming for OVC forachieving greater impacts?

12. What responses are planned by UNICEF to prevent violationsof rights of children?

13. Who are the major players involved in child protection andchildren affected HIV/AIDS? a) Public sectors ( gather details) Private sectors

14. Which major multilateral / bilateral agencies that areproviding resources for protection and HIV/AIDS work?

15. What are the specific technical expertise needed to scaleup prevention, care and support responses through childprotection programs

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Schedule B: HIV and AIDS Specialists(UNICEF/SCUSA/INGOS/Bilateral Agencies)

1. What are the national HIV/AIDS strategic plans for care andsupport of OVC?

2. Who are the most vulnerable subpopulations of children? Howdoes HIV/AIDS impact these groups?

3. What is the range of different protection problems faced byCABA and other OVC?

4. What are the existing care practices/programmes and policiesfor vulnerable CABA?

5. Can you tell us about convergence of all services?

6. What is the level of investment for care and support ofHIV/AIDS affected OVC?

7. In your opinion, who gets more resources: OVC or CABA?

8. What national frameworks exist to address issues related toHIV/AIDS?

9. What are the strategies in place in care and support of allvulnerable children?

10. What are the existing policies for CABA? Do they focus onchild protection?

11. What are the community-based care practices for OVC?

12. Are there any strategic plans/documents in place with theorganizations working on child protection (child protectionas an organizational policy)?

13. What is the government commitment towards child protectionin terms of programmes, policies and budget allocation?

14. What are the legal frameworks to protect OVC(international - as the country signatory to theseinternational legal frameworks)?

15. Is there any mainstreaming of HIV/AIDS and children’sissues into key programme and development areas?

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Schedule C: Government Counterparts

1. What are the national policies and programmes for OVC inyour country?

2. Are there any national policies and guidelines for OVC?Any specific laws protecting the rights of all children?

3. Factors affecting vulnerability:a. What are main factors affecting vulnerability of

children?b. Can you list the categories of vulnerable children?c. What are the problems faced by OVC (general) and OVC

by HIV/AIDS?

4. Have you considered HIV/AIDS and poverty vulnerabilityfactors in care and support policies for OVC?

5. How are the definitions of orphans and children orphanedby HIV/AIDS differentiated? Does this definition cover oraddress specific vulnerabilities faced by CABA?

6. Are there any specific social exclusion practices that

impact the access to services by OVC and those affected byHIV/AIDS?

7. Has there been situational analysis or assessment of OVCin the country? Are we able to quantify the number of OVCin the country? If yes, who is conducting theseassessments?

8. What are the coordination mechanisms that exist? Withwhich ministries do you coordinate? Is the coordinationmechanism institutionalized?

9. Is there integration of child protection HIV/AIDS intoSWAPs? And integration of HIV and AIDS in child protectionnational policies?

10. What is state support for OVC issues (education/foodsecurity and child protection)? What is the budgetaryallocation to these issues?

11. What are traditional practices for care and supportof OVC? Has HIV and AIDS influenced the care practices?

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12. Are there any similarities between HIV/AIDS andchild protection programmes? If yes, can you elaborate?

13. What are the key programmatic differences betweenchild protection and HIV/AIDS?

14. What barriers do you foresee in the integration ofHIV/AIDS into child protection programmes?

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Annex III: List of Key Informants in India, Bangladesh andNepal

Organisations/Agencies

India Bangladesh Nepal

UNICEF Ivonne Cameroni Chief, HIV/AIDS Section

Bridget - HIV/AIDS Specialist

Beth Verhey Chief-Social Policy and Decentralisation

Kiki Van KesselChild ProtectionUnit

Sanja Saranovic Child ProtectionSpecialist

Joanne DoucetChief Child Protection

Sony Kutty George Child Protection

Dr. Nazmul Shabnaz,HIV/AIDS Section

Birendra B. Pradhan Project Officer

Sudha MuraliChild ProtectionSpecialist UNICEF Hyderabad

- Thakur Dhakal Programme Officer – SocialPolicy & Decentralisation

Mr. LaxminarayanNanda HIV and AIDS/Child Protection Specialist, UNICEF Bhubaneshwar

- Bhanu Pathak Child ProtectionSpecialist

-

Save the Children Dr. Joe ThomasSouth Asia Regional AdvisorSave the Children UK

Dr. NizamHIV/AIDS Specialist and South Asia AdvisorSCUSA

Sita Ghimire Deputy Director & Team Leader - Protection

- Child ProtectionWorking Group – Save Alliance Bangladesh (SCUSA, SCUK, SC Australia and SCSweden and Denmark)

Satish Raj Pandey -Deputy Director

- - Lok raj Bhatta

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Sr. Programme CoordinatorGlobal Fund

Ministry of Womenand Child

Development/Social Welfare

Mr. RejoniaHIV/AIDS Focal Person

Dr. Nomita Haldar Deputy Secretary

Laxmi Prasad Tripathi Under Secretary

- Zulfikar Hyder Additional Director,Department of Social Welfare

-

- Masooma Akhtar Deputy Director,Institutions Department of Social Welfare

-

HIV/AIDS and STIControl

Board/NationalAIDS Control

Organisation/National AIDS and STDPrevention Board

Dr. Damodar BachaniAdditional DG,NACO

Dr. Hasan MohamudDeputy ProgrammeManager NASP

Damar Prasad GhimireDirector/ MemberSecretary

- - Sanjay Rijal Monitoring & Evaluation Officer

Family HealthInternational

Dr. Bitra GeorgeCountry Director,

- Bushan Shrestha Team Leader

ClintonFoundation

Supriti Chakraborthy Programme Manager

- -

FXB IndiaSuraksha

Biswajit Panda Programme Director

- -

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Annex IV: Commonalities in Child Protection Programming Approaches across India, Bangladesh, and Nepal

Agencies Bangladesh Nepal IndiaGovernment Ministry of

Health and Family Welfare

Ministry of Women, Child and Social Affairs

Ministry of Women and child Development

Ministry of Social Justice and Empowerment

Ministry of Education

Police

Central Welfare Board/Juvenile Justice Board

Swadhar Programmes

Short Stay Homes

Sishu Greha

Child Rights Commission

Multilateral

UNICEF/UNAIDS/UNFPA/UNIFEM

UNICEF/UNAIDS/ UNFPA/UNIFEM

UNICEF/UNAIDS/ UNFPA/UNIFEM

Banks WB/ADB WB/ADB WB/ADBBilateral USAID/DFID AusAID/USAID/DFID AUSAID/DFID/USAID/

EU/GTZCorporates NA NA IKEA/WIPRO/Bill &

Melinda Gates Foundation/ Clinton Foundation

Civil Society Organizations

Positive People’s Network

- PWN+, CACT/CACL networks

INGOs Save the Children/ FHI/PSI/TDH/PlanInternational

Save the Children/ FHI/PSI/TDH/Plan International

Save the Children/The India HIV/AIDS Alliance/FHI/PSI/TDH/

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Plan International

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Annex V: Explanatory Notes

During the discussions with interviewees and desk review, it was realized that there was lack of clarity on the difference between child protection, protection of all rights and social protection. The following note on what researchers meant by child protection is offered for clarity.

This study recognises that child protection has a specificmeaning and is different from “protection of all rights”. Anyprogramme on child protection would involve strengthening ofprotective factors, protecting children from harm andpreventing further vulnerability. Any deliberate act, or anyfailure to act that leads to harm to individual children orsubpopulations of children. Harm can be caused by abuse,neglect and exploitation. Violence is a result of all three ofthe above. However, there is debate among child protectionactivists about whether to include violence in the definitionof harm to children.

The UNCRC lists specific protection rights—every child has theright to be protected from: Art. 19: Physical and mental violenceArt. 20: Being separated from their family against their willArt. 32: Economic exploitation and harmful workArt. 35: Sale, trafficking and sexual exploitationArt. 34: All forms of sexual exploitation and abuseArt. 37: Torture and other cruel, inhuman or degradingtreatment or punishmentArt. 38: The effects of armed conflictArt. 40: Protection of children in conflict with law

These rights are furthered strengthened with specificprovisions in two optional protocols on the sale of children,child prostitution and child pornography, and the involvementof children in armed conflict.

Child protection programmes aim to respond to and preventabuse, neglect and exploitation of children to ensure thattheir rights to survival, development and participation areprotected.

Protection of child rights includes programmatic actions,approaches and strategies to ensure access to all children’srights as enshrined in the UNCRC. However strengthening

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protective factors would mean ensuring complete access toeducation, health and other basic services.

Social protection comprises actions (usually by the government)to address not only income poverty and economic blocks, butalso social vulnerability. Such actions include policies,services, and transfers of cash or other allowances. Socialprotection mitigates against growing inequalities in povertyand addresses social exclusion challenges in meeting theMillennium Development Goals.45

Child protection policy is an organizational policy which manyorganizations working with children are developing. The policyaims to protect children from misdemeanours by their staff, andgenerally includes a code of conduct that all staff,volunteers, partners, vendors and any service providers mustadhere to, so that children are not put at risk by any adultthey come into contact with through the organization. Thepolicy lays down standards, regulations and response mechanismsfor violations of the code of conduct. The recruitment andinduction training typically ensures that all staff is:

Aware of the problem of child abuse Safeguard children from abuse Report all concerns about possible abuse Respond appropriately when abuse is discovered or

suspected Recruitment of individuals who can be potential abusers

45 This definition is from a concept paper on “Social Protection In Nepal: Introducing Child Benefits” by Beth Verhey, Chief, Social Policy, UNICEF Nepal.

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