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Situational analysis of orphaned and vulnerable children in eight Zimbabwean districts Biomedical Research and Training Institute in collaboration with the National Institute of Health Research of the Ministry of Health and Child Wellfare www.hsrcpress.ac.za from download Free This work was made possible through funding provided by the World Health Organization (WHO) via Lancaster University. It was undertaken as work for the Social Exclusion Knowledge Network (SEKN) established as part of the WHO Commission on the Social Determinants of Health (CSDH). The views presented in this report are those of the authors and do not necessarily represent the decisions, policy or views of WHO or CSDH commissioners. www.hsrcpress.ac.za Published by HSRC Press Private Bag X9182, Cape Town, 8000, South Africa from www.hsrcpress.ac.za First published 2008 download ISBN 978-0-7969-2234-2 Free © 2008 Human Sciences Research Council Print management by Greymatter & Finch Printed by RSA Litho Cover image © David Larsen/The Media Bank/Africanpictures.net. Young children at Chimbuwe Primary School, in the Kaitano area, Zambezi Valley, Zimbabwe. Distributed in Africa by Blue Weaver Tel: +27 (0) 21 701 4477; Fax: +27 (0) 21 701 7302 www.oneworldbooks.com Distributed in Europe and the United Kingdom by Eurospan Distribution Services (EDS) Tel: +44 (0) 20 7240 0856; Fax: +44 (0) 20 7379 0609 www.eurospanbookstore.com Distributed in North America by Independent Publishers Group (IPG) Call toll-free: (800) 888 4741; Fax: +1 (312) 337 5985 www.ipgbook.com CONTENTS List of tables and figures vii Acknowledgements viii Contributors ix Acronyms and abbreviations x Executive summary xii Chapter 1 Introduction 1 HIV/AIDS and the OVC problem in Zimbabwe 1 Responses to HIV/AIDS and the OVC problem 3 Background to the OVC project 6 Goals and aims of the OVC project 6 Objectives of the situational analysis study 7 Chapter 2 Methodology 9 Methodology 9 Operational definitions 9 Study areas 10 Fieldworkers 11 Data collection methods and tools 11 Ethical issues, consent and confidentiality 14 Analysis and report writing 14 www.hsrcpress.ac.za Chapter 3 Zvimba District 15 Background 15 from Conditions of OVC 17 Care and support structures for OVC 22 Policy and legislation for the protection of OVC 26 HIV and AIDS 27 download Profile of government departments 32 Profile of NGOs and other organisations 38 Free Conclusions 45 Priorities for action 47 Chapter 4 Bindura District 49 Background 49 Conditions of OVC 52 Care and support structures for OVC 57 Policy and legislation for the protection of OVC 61 HIV and AIDS 62 Profile of government departments 66 Profile of NGOs and other organisations 72 Conclusions 79 Priorities for action 81 Chapter 5 Nyanga District 83 Background 83 Conditions of OVC 84 Main needs and problems of OVC 88 iii Situational analysis of orphaned and vulnerable children OVC access to facilities 88 Challenges and coping mechanisms 89 Attitudes, stigma and discrimination 90 Challenges and complications 91 Suggestions on how to help OVC 93 Care and support structures for OVC 94 Policy and legislation for the protection of OVC 97 HIV and AIDS 99 Care and treatment for PLWHA 101 Suggestions on how to limit the spread of HIV/AIDS 102 Major sources of information on HIV/AIDS 104 Profile of government ministries and departments 105 Profile of non-governmental organisations 108 Conclusions 109 Priorities for action 110 Chapter 6 Mutasa District 113 Background 113 Conditions of OVC 114 Main needs and problems of OVC 116 Access to facilities 117 Challenges and coping mechanisms 119 Attitudes, stigma and discrimination 119 Challenges and complications 120 www.hsrcpress.ac.za Suggestions on how to help OVC 124 Care and support structures for OVC 125 from Policy and legislation for the protection of OVC 127 HIV and AIDS 129 Care and treatment of PLWHA 131 download Suggestions on how to limit the spread of HIV/AIDS 132 Major sources of information on HIV/AIDS 133 Free Profile of government ministries and departments 135 Profile of non-governmental organisations 137 Conclusions 139 Priorities for action 141 Chapter 7 Mutare District 143 Background 143 Conditions of OVC 144 Major threats to OVC quality of life 146 Access to facilities 147 Attitudes, stigma and discrimination 148 Challenges and complications 149 Suggestions on how to help OVC 150 Care and support structures for OVC 151 Policy and legislation for the protection of OVC 152 HIV and AIDS 153 Care and treatment of PLWHA 155 Major sources of information on HIV/AIDS 157 Risks of HIV/AIDS as a result of violence 158 iv Contents Profile of government departments 158 Profile of non-governmental organisations 160 Conclusions 162 Priorities for action 164 Chapter 8 Chimanimani District 165 Background 165 Conditions of OVC 168 Major threats to OVC quality of life 170 Access to facilities 170 Attitudes, stigma and discrimination 171 Challenges and complications 171 Suggestions on how to help OVC 172 Care and support structures for OVC 173 Policy and legislation for the protection of OVC 175 HIV and AIDS 175 Suggestions on how to limit the spread of HIV/AIDS 177 Care and treatment of PLWHA 177 Major sources of information on HIV/AIDS 178 Profile of government departments 179 Profile of non-governmental organisations 181 Conclusions 182 Priorities for action 183 www.hsrcpress.ac.za Chapter 9 Bulilima and Mangwe Districts 185 from Background 185 Conditions of OVC 191 Care and support structures for OVC 197 Attitudes of the community towards OVC 200 download Suggestions on how to help OVC 201 Policy and legislation for the protection of OVC 203 Free HIV and AIDS 204 Care and treatment of PLWHA 206 Major sources of information on HIV/AIDS 207 Risks of HIV/AIDS as a result of violence 208 Suggestions on how to limit the spread of HIV/AIDS 209 Profile of government departments 210 Profile of non-governmental organisations 217 Conclusions 224 Priorities for action 225 Chapter 10 Gweru Urban District 227 Background 227 Conditions of OVC 229 OVC needs and concerns 230 Major threats to OVC quality of life 230 Access to facilities 230 Attitudes, stigma and discrimination 231 Challenges and complications 231 v Situational analysis of orphaned and vulnerable children Care and support structures for OVC 232 Suggestions on how to help OVC 232 Policy and legislation for the protection of OVC 233 HIV and AIDS 233 Suggestions on how to limit the spread of HIV/AIDS 234 Care and treatment of PLWHA 234 Risks of HIV/AIDS as a result of violence 235 Major sources of information on HIV/AIDS 235 Profile of government departments 236 Profile of non-governmental organisations 238 Conclusions 243 Priorities for action 244 Chapter 11 Conclusions and recommendations 245 Magnitude and living situation of the OVC 245 Care and support 245 Community resources 245 Support structures 245 Community attitudes towards OVC 246 Services available for OVC care 246 Awareness of HIV and AIDS 246 Recommendations 246 www.hsrcpress.ac.za Appendix: Interview and discussion guidelines 249 from References 261 download Free vi LIST OF TABLES AND FIGURES Tables Table 2.1: Distribution of respondents who participated in the in-depth interviews, by district 12 Table 2.2: Distribution of government departments’ representatives interviewed, by district 12 Table 2.3: NGO/CBO/FBO representatives interviewed, by district 13 Table 3.1: Levels of education for 3- to 24-year-olds in Zvimba District 16 Table 3.2: Student enrolment for year 2005 at Murombedzi Vocational Training Centre 38 Table 3.3: Monthly tonnage of food distributed 40 Table 4.1: Levels of education for 3- to 24-year-olds in Bindura Rural District, by percentage 51 Table 4.2: Levels of education for 3- to 24-year-olds in Bindura Urban District, by percentage 51 Table 4.3: Levels of education for 3- to 24-year-olds in Bindura District, by percentage 51 Table 5.1: Clinics and hospitals in Nyanga District 83 Table 5.2: Levels of education for 3- to 24-year-olds in Nyanga District, by percentage 84 Table 5.3: Profile of government ministries and departments 105 Table 5.4: Profile of non-governmental organisations 108 Table 6.1: Number of school-going children enrolled in 2006 113 Table 6.2: Levels of education for 3- to 24-year-olds in Mutasa District, by percentage 114 www.hsrcpress.ac.za Table 6.3: Profile of government ministries and departments 135 Table 6.4: Profile of non-governmental organisations 137 from Table 7.1: Levels of education for 3- to 24-year-olds in Mutare District, by percentage 143 Table 8.1: Clinics and hospitals in the district 167 Table 8.2: District staff complement, by designation 167 download Table 8.3: Levels of education for Chimanimani District 168 Table 9.1: Distribution of population by age group and sex in Bulilima, Mangwe Free and Plumtree Districts 186 Table 9.2: Size of orphanhood, by district 186 Table 9.3: Population distribution by orphanhood status, by district 186 Table 9.4: Prevalence of disability in households with children, by district 189 Table 9.5: Population distribution by level of education attained in the districts 190 Table 9.6: Reasons for children who had never gone to school in the districts 190 Table 9.7: Statistics of PLWHA: Plumtree District Hospital 211 Table 9.8: Staff complement: Plumtree District Hospital 211 Table 9.9: Distribution of BEAM beneficiaries 2005 213 Table 9.10: Food assistance (maize) 213 Table 10.1: Partners involved in the project, MASO Gweru 241 Figures Figure 2.1: Map showing provinces in Zimbabwe 10 Figure 3.1: Distribution of population by age group and sex, Zvimba District 15 Figure 4.1: Distribution of population by age group and sex, Bindura District 49 Figure 8.1: Chimanimani age distribution 165 Figure 8.2: Orphanhood among children under 18 years 166 Figure 10.1: Population distribution by age group and sex, Gweru Urban District 227 vii ACKNOWLEDGEMENTS We would like to acknowledge the contribution of the following in bringing this document into being: • Contributions to this report have been made by members of the research team who are listed in the authorship section and under various chapters.