OVC Support Toolkit 

Health and nutrition

This section looks at the health and nutrition of orphans and other vulnerable children. It looks at ways in which the effects of HIV/AIDS on the health and nutrition of children can be measured and the ways in which HIV/AIDS causes its effects on the health and nutrition of orphans and other vulnerable children. It also looks at what rights orphans and other vulnerable children have regarding health and nutrition and what actions can be taken to improve their health and nutrition. Other sections look in more detail at health and nutrition of orphans and other vulnerable children, in general, and children living with HIV/AIDS, in particular.

Key points about health and nutrition are:

1. HIV/AIDS is having severe effects on the health and nutrition of children. In countries with severe HIV/AIDS epidemics, this is seen in increasing rates of under-5 mortality.

2. HIV/AIDS affects the health of children directly and indirectly.

3. It is possible to approach this issue by considering the rights that children have regarding health, and examining how these rights are abused in relation to HIV/AIDS.

4. Ways in which the effects of HIV/AIDS on the health of children can be reduced include effective HIV prevention; health education for children and caregivers; strengthening nutrition and food production; and improving access to health services in general and antiretrovirals, in particular.

Effects of HIV/AIDS

HIV/AIDS is having severe effects on the health and nutrition of children. In countries with severe HIV/AIDS epidemics, this is seen in increasing rates of under-5 mortality. In some other countries, with lower rates of infection, under-5 mortality rates have either not risen or fallen as a result of other factors.

HIV/AIDS affects the health of children in a number of different ways including:

• Directly, when children themselves are infected with HIV.
• As a consequence of parental illness and death. Children born to HIV positive women are more likely to die before the age of five than other children. This risk applies to all these children and not just those who are HIV-infected themselves. Also, children are at a high risk of dying soon after their mother dies. This risk applies regardless of cause of death. However, many studies have shown that orphans do not usually have more health problems than non-orphans in the same community.
• By making children more vulnerable to other infections. For example, children, in general, are more vulnerable to tuberculosis as a result of HIV/AIDS because of greater exposure to the disease. Children living with HIV/AIDS are more vulnerable to tuberculosis because of reduced immunity.
• Through the impoverishing effects of HIV/AIDS. One of the impacts of HIV/AIDS on children, their families and communities is worsening poverty. This affects the health and nutrition of children in a number of ways. Families are less able to afford health care and other measures to prevent disease, such as the purchase of mosquito nets. In addition, poor people often have poorer nutrition, housing, hygiene and water. All these have effects on the health of children.
• Orphans and other vulnerable children are more likely to be involved in work. Such child labour is often unregulated and may expose them to a variety of health hazards, including chemicals and pesticides.
• Orphans and other vulnerable children may be less able to access health care than other children.
• HIV/AIDS has reduced the ability of health systems to cope and deliver services. This is because of the increased demand for services as a result of HIV/AIDS and the reduced ability to deliver services because of illness and death of health personnel.
• HIV/AIDS may have negative effects on the growth and development of children. Causes of this could include poverty and illness of the parent and/or the child. However, studies have produced different results. Some have shown that orphans are more likely to be underweight, wasted or stunted than non-orphans, while other studies have failed to show any difference.

Children's Health Rights

The Convention on the Rights of the Child includes specific rights regarding health. Examples of these include the right to medical confidentiality, the right to informed consent and the right to access to basic health care services. In many situations, orphans and other vulnerable children do not enjoy the benefits of these rights.

Reducing the Effects of HIV/AIDS on Children's Health

There are many different ways in which the effects of HIV/AIDS on the health of children can be reduced. These include:

• Promoting effective methods to prevent the further spread of HIV/AIDS.
• Through health education of children and their caregivers.
• Through a variety of measures which make health services more accessible and appropriate for children. Provision of effective health services for children's caregivers will also have effects on the health of children.
• Ensuring that health facilities provide good quality services, particularly for children living with HIV/AIDS.
• Improving access to treatment with antiretroviral drugs.
• Steps to improve children's nutrition, including initiatives to strengthen household food production.

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