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AIDS Behav (2006) 10:619–626
DOI 10.1007/s10461-006-9086-6
ORIGINAL PAPER
Towards a Definition of Orphaned and Vulnerable Children
Donald Skinner ·N. Tsheko ·S. Mtero-Munyati ·
M. Segwabe ·P. Chibatamoto ·S. Mfecane ·
B. Chandiwana ·N. Nkomo ·S. Tlou ·G. Chitiyo
Published online: 26 April 2006
C
Springer Science+Business Media, Inc. 2006
Abstract The HIV epidemic presents challenges including
orphans and a large mass of children rendered vulnerable by
the epidemic and other societal forces. Focus on orphaned
and vulnerable children (OVC) is important, but needs ac-
curate definition. Twelve focus group interviews of service
providers, leaders in these communities, OVC and their care-
takers were conducted at six project sites across Botswana,
South Africa and Zimbabwe to extend this definition. The
loss of a parent through death or desertion is an important
aspect of vulnerability. Additional factors leading to vulner-
ability included severe chronic illness of a parent or care-
giver, poverty, hunger, lack of access to services, inadequate
D. Skinner ()·S. Mfecane ·N. Nkomo
Social Aspects of HIV/AIDS and Public Health (SAHA), Human
Sciences Research Council (HSRC),
Private Bag X9182, Cape Town, 8000 South Africa
e-mail: Dskinner@hsrc.ac.za
N. Tsheko
Dept of Education, University of Botswana,
Gaberone, Botswana
S. Mtero-Munyati
National Institute of Health Research,
Harare, Zimbabwe
M. Segwabe
Dept of Health and Wellness, University of Botswana,
Gaberone, Botswana
P. Chibatamoto ·B. Chandiwana ·G. Chitiyo
Biomedical Research & Training Institute-Centre for International
Health and Policy BRTI-CIHP,
Harare, Zimbabwe
S. Tlou
Minister of Health,
Gaberone, Botswana
clothing or shelter, overcrowding, deficient caretakers, and
factors specific to the child, including disability, direct ex-
perience of physical or sexual violence, or severe chronic
illness. Important questions raised in this research include
the long-term implications for the child and community, and
the contribution of culture systems.
Keywords Orphans .HIV .AIDS .Orphaned and
vulnerable children .Definition .Sub-Saharan Africa
Introduction
The importance of considering the situation of children or-
phaned by AIDS has been made clear both by projections of
the number of orphans expected, and the lack of adequate
caring mechanisms and service structures to support them.
However, looking at the situation of these orphans does not
address the full scale of the problem, since the epidemic and
surrounding poverty are generating a context in which large
numbers of children are becoming vulnerable. The term or-
phaned and vulnerable children (OVC) was introduced due
to the limited usefulness of the tight definition of the con-
struct of “orphanhood” in the scenario of HIV/AIDS [15].
The term OVC in turn has its own difficulties as a construct,
since it is has no implicit definition or clear statement of
inclusion and exclusion. It therefore works as a theoretical
construct, but requires explanation and definition at ground
level.
Orphans are the focus of much academic and popular
writing. Such work includes counts or projections of num-
bers of orphans [4,6], examination of interventions required
to provide adequate assistance [2,6,18], descriptions of
the context and caring of orphans [1,4,11], and descrip-
tions of the impact of HIV on children [1,3,18]. Some of
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620 AIDS Behav (2006) 10:619–626
the material, particularly that in the popular literature, has
sensationalized the issue. Examples of the “worst-case” stud-
ies of orphans are identified and these situations are extrap-
olated to all orphans in the region [9,14]. Some projects
have more recently extended their scope and worked more
with the concept of vulnerability and services to assist these
children [8,17,20].
An orphan is defined by UNAIDS as a child under 15
years of age who has lost their mother (maternal orphan)
or both parents (double orphan) to AIDS [16]. Many re-
searchers and intervention groups usually increase the age
range to 18 years, but a number appear to use the UNAIDS
definition. It is also being more generally accepted that the
loss of the father would also classify the child as an orphan
[13]. The UNAIDS definition has come under criticism for
its lack of breadth and sensitivity to the situation on the
ground for many children [7]. The criticism acknowledges
that increasing the age covered by the definition to 18 does
have policy implications, since this definition increases the
number of children affected, but the context demands this
acknowledgement [7].
Within the orphan grouping, layers of vulnerability are
addressed as one system for adding descriptive understand-
ing to the context of the OVC [4,6]. There appear to be some
implicit classification systems for orphans, such as the na-
ture of their caregivers i.e., extended families, foster parents,
community caregivers, child-headed households and those
under institutional care [11], the level of additional assis-
tance that is required [2,6], and between maternal, paternal
and double orphans [6,11].
“Vulnerability” is much more difficult to define. The
complexity increases when it is considered that this defini-
tion needs to guide work with children in multiple contexts
around the world, and needs to avoid being construed as
stigmatizing. World Vision [21] listed some identifiers, such
as children who live in a household in which one person or
more is ill, dying or deceased; children who live in house-
holds who receive orphans; children whose caregivers are
too ill to continue to look after them; and children living
with very old and frail caregivers. A consultative meeting in
Kenya defined children as vulnerable if they lived in house-
holds with a chronically ill parent or caregiver, and in terms
of access to key resources such as food, shelter, education,
psychosocial and emotional support and love [10]. These
categories focus on factors related to HIV. There is an entire
set of variables that needs to be considered that relate to more
general aspects of the child’s context, such as poverty, access
to shelter, education and other basic services, disability, im-
pact of drought, stigma and political repression—all factors
that could influence vulnerability [12].
A range of definitions has been used for describing vul-
nerability in children across a number of African countries
[15]. In Botswana, children seen as vulnerable were street
children, child laborers, children who are sexually exploited,
who are neglected, those with handicaps and children in
remote areas who are part of indigenous minorities. By
contrast, in Rwanda, vulnerable children include those in
child-headed households, in foster care, in institutions, in
conflict with the law, street children, disabled children, chil-
dren affected by armed conflict, children who are sexually
exploited or abused, working children, children with par-
ents in prison, children in very poor households, refugee or
displaced children and children who get married before the
age of majority. The definition of vulnerable children from
South Africa included those children who are neglected, des-
titute or abandoned, living with terminally ill parents, those
born to single mothers, with unemployed caretakers, who are
abused or ill-treated by caretakers or are disabled. Finally,
in Zambia, a state of vulnerability was assigned to children
who were not at school, children from female/aged/disabled-
headed households, children whose parents are ill, children
from families where there is insufficient food, and children
who live in poor housing.
With the creation of terms to name or define a group, espe-
cially a group seen to be having as many problems as OVC,
they become objectified or automatically become targets for
stigma. Care must therefore be taken with how the term is
used, in both the academic and popular literature, as well as
in care programs. [5].
Community definitions of the orphan and the vulnerable
child are also often different from the definitions used by
government and external agencies. For instance, assistance
to children by the government is directed by particular age
limits—any child that falls outside those limits may be ex-
cluded. There was general consensus during the focus groups
that the government should adopt a “bottom-up” approach,
taking guidance from community level when setting param-
eters for assistance. To get a real sense of where to introduce
interventions or support, a clear understanding of the com-
munity’s perspective is required. Time has to be spent in the
community listening to people who are doing work there al-
ready, particularly the caretakers and the vulnerable children
themselves. Work in this project, to obtain a common defini-
tion of OVC across the three countries of Botswana, South
Africa and Zimbabwe, is one contribution to establishing
a basic definition that can be used as a basis for planning
around OVC at a general level, while acknowledging the
specifics of each intervention site.
Methods
This research forms part of a much larger study aimed at
developing interventions with OVC across seventeen re-
search sites in Botswana, South Africa and Zimbabwe. The
full study has multiple objectives, with the key aim being
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AIDS Behav (2006) 10:619–626 621
Table I. Site of interviews
with nature of the respondents
and number in each group
Site of interviews Nature of the respondents Number
Botswana
Letlhakeng Primary caregivers in households of OVC 8
Letlhakeng Community leaders including a chief and teachers and
NGO staff including nurses and family welfare officers
10
Palapye Members of the dominant NGO providing services,
primary caregivers in households of OVC and OVC
10
Zimbabwe
Bulilimamangwe Traditional Chiefs and Headmen, Rural district council
officers, social welfare representatives, local government
representatives, staff of NGOs working with OVC
14
Bulilimamangwe Primary caregivers in households of OVC including
parents, volunteers who assist in the care of OVC and
Church members who also provide assistance
30
Chimanimani Traditional Chiefs, Rural district council officers, social
welfare representatives, local government representatives,
staff of NGOs working with OVC
15
Chimanimani Primary caregivers in households of OVC including
parents, volunteers who assist in the care of OVC and
Church members who also provide assistance
20
South Africa
Mathjabeng Department of Health (DoH) home based caregivers for
people with HIV/AIDS, DoH official and representatives
from faith based organisations (FBO)
15
Mathjabeng Representatives from a day care centre, an FBO and an
NGO providing support to OVC and interested members
of the community
9
Mathjabeng Members of a the local task team set up to address issues
of OVC, including representatives from the DoH, Dept.
of Social Development and NGOs
8
Klerksdorp Representatives from NGOs, a traditional healer and a
volunteer from a local clinic
12
the development, implementation and evaluation of best
practice interventions for OVC as well as their households
and communities, to act as models for other sites in Africa
and further afield. The aim of these interviews was to obtain
a definition of OVC drawn from and having meaning for the
communities in which the research project is being done.
Ethical approval was this work was obtained as part of the
ethical approval of the entire study from the ethics board of
the University of the Witwatersrand in Johannesburg.
Research design and sample
The essential method of obtaining a definition was via focus
group discussions with people in the communities, includ-
ing service providers and orphans and caretakers, as well as
broader members of the community. Group members were
recruited on a purposive basis to try to ensure that there was
an adequate representation of different sectors of the com-
munity who have contact with and work with OVC. These
interviews were done as a first phase of research during the
initial period of meeting with communities and requesting
access, so would have been the first contact with people in
the communities. The full list of interviews undertaken is
provided in Table 1. All interviews were conducted in the
language of the persons being interviewed.
Research question
Rather than using a fixed question or discussion schedule,
the following statement was read to the group as a basis for
discussion:
With the HIV epidemic, poverty and other social prob-
lems, many children have been put at risk by the loss of
parents or the increasing pressure that the epidemic and
poverty have put on their community. The vulnerability
can be seen in terms of illness, unemployment, violence,
HIV, crime, desertion, etc. We are looking for a definition
of such a vulnerable child. The definition will be used
to guide a community-wide intervention directed at or-
phaned and vulnerable children, and will act a basis for
the research. To repeat, we would like to get a definition of
those children the community considers to be vulnerable.
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622 AIDS Behav (2006) 10:619–626
A checklist of the major potential areas of vulnerabil-
ity also guided the interviewers. These included princi-
pally the age limitations to childhood, definitions of or-
phanhood and vulnerability, indicators of vulnerability and
orphanhood. Within the definition of vulnerability inter-
viewers were asked to check specifically for issues around
hunger, loss of schooling, illness, emotional issues, loss of
resources, loss of caretakers, and also to probe for any new
ideas from the group members. Finally for the identifica-
tion of and provision of services for OVC, interviewers
were also asked to identify differences between a vulner-
able child and a secure child, places and situations where
these children would be found, and to specify the rights of
the OVC to services, inherited property, security, a home,
food, etc.
Analysis
A thematic content analysis method was used in analyzing
the data. The analysis went through a number of stages.
Transcriptions of audiotapes of the groups were used for the
analysis. The researchers in each country developed a report
based on the interviews done there using a content analysis
method. The content analysis was done by hand, without
the use of computer programs. There was no fixed process
to the analysis nor were there preset critical themes, other
than what was provided in the research question. However
the researcher had met previously and discussed the research
question and approach, so there was a common understand-
ing as to the nature of the task and the analysis required. The
authors of the study were responsible for the analysis, all of
which have considerable experience in qualitative analysis.
Again there had been discussion on methods of analysis at
a previous inter-country meeting to agree on an overall ap-
proach. The process was not overly pre-structured to limit
the potential for bias and to allow for new ideas to emerge
from each country. The reports were then drawn together
into this document. All the research staff that worked on es-
tablishing definition reports for their own countries and sites
agreed on the final analysis and definition as outlined in this
document.
Within this document the construct for the OVC requires
consideration of a number of components of the broad term,
i.e. definition of a child and of an orphan, and of what consti-
tutes vulnerability. These sub-definitions were outlined first,
before the full definition was drawn together. There was con-
siderable agreement on many of the constructs across all the
groups and sites in the three countries. Some important varia-
tions in and nuances to the explanations according to context
have to be addressed.
Results
Definition of a child
A child is primarily defined by age, with most common
agreement being 18 years, which is the legal age of major-
ity in many of the sub-Saharan countries. Ultimately, age
definitions were felt to depend on the period of dependence
of the child on the parents or caretakers of the household.
The period of dependence could be extended considerably by
many situations, including unemployment, extended studies,
physical or mental handicap, or severe illness. Such individ-
uals would not be considered as children, but would remain
dependent and remain part of the load on the household.
Definition of an orphan
The most accepted definition of an orphan is a child who has
lost one or both parents through death. This definition was
immediately extended in most of the groups to include loss
of parents through desertion or if the parents are unable or
unwilling to provide care. In most cases the absent parent
is the father. The feeling among some respondents was that
fathers seldom return, even after the death or absence of the
mother.
An initial question often raised was whether the loss of
one parent constituted orphan status, and whether there was
a difference according to which parent died or left. For most
the loss of one parent was sufficient to classify the child as
an orphan, especially if the primary caregiver was lost. A
distinction was made here between a wage earner, usually
the father, and a carer at home, usually the mother. Both were
considered vital to the survival of the household and for the
healthy development of the child.
A second concern was whether the child who still had
a caregiver should be considered an orphan, since they still
have extended family or caregivers from their community.
This was raised particularly in view of the African context,
where many stated that “orphan” is not a recognized term.
Group participants pointed out that their community is not
aware of the difference between orphan and a vulnerable
child: “...a child remains a child right through, that is the
African culture”. However, others in the same group felt that
some distinctions are made between orphaned and other vul-
nerable children, which impact on the provision of assistance
to the children concerned.
The claim that African culture did not define orphan status
was contradicted by statements made in one of the groups
from Botswana. According to them, in Setswana there are
two terms that describe an orphan: “lesiela” (lost one parent),
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AIDS Behav (2006) 10:619–626 623
and “khutsana” (lost both parents). “Lesiela” is widely used
because it is user-friendly and less derogatory; with “khut-
sana,” there is the implication that the child has absolutely
nobody to care for him or her, which is contrary to extended
family norms. The absence of guardians certainly increased
the potential vulnerability of the orphan. In Zimbabwe
orphans were divided into two groups, those with and those
without guardians. This emphasized the point made in many
of the groups that being an orphan did not always mean that
the child became vulnerable—it would depend on the quality
of caretaking from there on.
It was often stated in the groups that in African culture as
soon as a child was in need they would be cared for. While
the sentiment is generous, there are many children who have
had to suffer in communities without adequate care, and
in fact have experienced abuse. The problem is even more
pronounced now with communities overwhelmed by the bur-
den of AIDS that is leaving behind considerable numbers of
orphans and vulnerable children. The extended family also
contributes to vulnerability on occasions, by taking from the
child their inheritance and family land, and even sometimes
abusing their social support grants. These are monthly grants
provided by government departments to assist in the ongo-
ing maintenance of orphaned and other children who live in
very poor circumstances. This contradiction has to be ad-
dressed, since romantic notions about care in Africa could
be detrimental to planning and leave children without care.
Definition of a vulnerable child
A vulnerable child was seen as someone who has little or no
access to basic needs or rights. They may have both parents,
but the child might be compromised in other ways. The
definition of vulnerability was felt to reflect certain aspects
of the context of the child. Participants drew on personal
experience, knowledge of context, and documents such as
national constitutions. Vulnerability was contextualized for
many as the child not having certain of their basic rights
fulfilled, and identification of problems in the environment
of the child or problems that the child faces.
The basic rights of children identified across the groups
were to a name and nationality including recognition via
birth registration; a safe home and community environment;
education; love; family care and support; sufficient food
and basic nutrition, protection from maltreatment, neglect,
abuse both in and outside the home; security from abuse
and violence from both the community and the government;
health care and good hygiene; recreational facilities; ade-
quate clothing; and the right to make choices concerning
their way of living, e.g., not being forced into early mar-
riage.
A set of inherent and contextual factors indicating vul-
nerability was also developed. This arose out of identified
problems or gaps in the provision of needs, or specific threats
that existed in the communities, and includes the individual,
family and community contexts that make the child vulner-
able.
Some specific indicators for vulnerability in children, any
physical or mental handicap or any other long-term diffi-
culty that would make it difficult for the child to function
independently; illness, either HIV or other major illness;
and emotional or psychological problems. Particularly in the
case of the latter indicators that need to be checked include
apathy or helplessness that might show in the child being un-
happy, dull, not performing well in class, being miserable or
demotivated; or neglect of schoolwork, not attending school
regularly, not performing well at school. Also at the physical
level indicators could include signs that the child does not
receive sufficient healthy food and constantly shows signs of
hunger; constantly showing signs of not sleeping well; has
poor hygiene or cannot engage in personal care; and does
not have clothing or clothing is dirty or damaged. The final
set of core indicators included abuse at emotional, physical
or sexual level; use of drugs, e.g., glue, alcohol, cigarettes,
marijuana or crack; and not receiving care, particularly love,
guidance and support.
The family situations that make the child vulnerable in-
clude caregivers who are not able or willing to care for
the children under their care, including alcoholic, poor and
emotionally disturbed parents; handicapped (physically and
mentally) or chronically very sick parents, e.g., confined to
bed; or parents or caregivers not equipped to provide the
care giving role. With the increasing pressure of the number
of children being orphaned the danger of households be-
ing overcrowded or the ratio of children to caregivers is too
high was raised. Of particular concern were abusive family
members or caregivers, including those who commit sexual
and/or physical abuse. The latter should also cover the use
of excessive discipline and corporal punishment. Children of
divorced parents were felt to be at risk. Finally there were
concerns that the caregivers may lack financial resources
to adequately care for the child; or lack skills in parental
guidance and direction.
The community context in which the child lives also in-
fluences vulnerability. The group members identified the fol-
lowing areas of concern in terms of risk of being exposed to
dangerous situations. Unsafe environments such as informal
settlements without adequate housing, lack of toilets lead-
ing to the presence of raw sewage, or high levels of crime
and exposure to and/or participation in crime, gangs and
drug use were particular external threats. A lack of facilities
for children to allow for safe entertainment and play, and
for extramural activities; was felt to possibly deny children
opportunities for enjoyment of the space of being a child
and put limits on development. High levels of poverty were
acknowledged as a general threat as this meant the child
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624 AIDS Behav (2006) 10:619–626
having to go without many crucial resources. Finally, there
were concerns about any community situations that prevent
children from having a normal life, e.g. obtaining schooling,
having time and space to play, being safe from physical or
emotional threats etc.
Vulnerability is not an absolute state. There are degrees
of vulnerability, depending on the situation of the child. As
shown above, a number of factors contribute to a child’s
vulnerability. Each of these could add to the cumulative load
that the child carries. The extent of the crisis and additional
problems associated with it will also affect the impact on the
child. Other factors that influence the impact of a stressor
include—the age at which the loss of parents and assets took
place, the state of development of internal resources within
the child, and any coping strategies or support structures put
in place. The most vulnerable are those children who have
no caretakers, with street children being the most vulnerable
among them. Street children are found at shops and malls,
on streets, in market areas and abandoned buildings, and at
road junctions and refuse disposal sites.
It is important to note that a balance of aspects in the
child’s context determines vulnerability, so even if one com-
ponent goes wrong the child could suffer considerably. One
example provided is that a child may be provided with all
their basic needs, but be abused by the caretaker. One group
expressed concern that although parents may show love and
care, and provide well for a child, they may also practice ex-
cessive discipline or abuse the child. Ultimately, each child
has to be examined individually to determine their own vul-
nerability, but it remains important to establish some central
constructs for this definition. There was a particular fear of
children being abused behind closed doors, and a sense of a
lack of power to do anything about the risk.
Families cannot be relied upon; a case of an uncle who
took children under his protection. It later turned out that
he was abusing them. We tried to call the police after we
visited him and found out but he has since disappeared.
He used to buy books, clothes, etc.; now these children
are at my home and my mother is also unemployed.
Definition of a caretaker
A caretaker is the person who plays the key caring role for
the OVC. The person should be able to provide all aspects
of care and be responsible for the child under their care. The
roles for caretakers are seen as being to protect the rights of
the children in their care as far as they are able; provision
of basic requirements of life and development such as shel-
ter, food, education, clothing and health care; provision of
environment for psychosocial development and to support,
moral, cultural and religious instruction, as well as basic
hygiene; being responsible if anything happens to a child
and being there to attend to the child; and ensuring that the
conditions exist for adequate emotional development.
In many debates there is talk of a primary caretaker, but
this needs further definition. In the focus groups there was
division as to whether the primary caretaker is the person
who provides emotional care, or the person who brings in
the financial support. While they were seen as separate with
strong gender overtones as to who could effectively provide
is each role, both were considered as being of key importance
to the ongoing survival of the child.
Overall definition
An overall definition is required for intervention and re-
search, which raises considerable complications—especially
if an absolute answer is sought. The definition needs rather
to incorporate a range of factors that may be important.
There appeared to be agreement that the age limit for def-
inition of a child should be 18 years. An orphan is a child
who has lost either one or both parents. The remainder of the
definition needs to centre around three core areas. The rela-
tive importance of each will be defined by context: Material
problems, including access to money, food, clothing, shelter,
health care and education; Emotional problems, including
experience of caring, love, support, space to grieve and con-
tainment of emotions; Social problems, including lack of a
supportive peer group, of role models to follow, stigma or
of guidance in difficult situations, and risks in the immedi-
ate environment; Vulnerability may be defined according to
what is immediately seen in a situation and what is more
easily measurable.
An initial attempt to operationalize and measure from the
definition is provided below. One danger of this approach is
that it is biased against hidden problems such as emotional
issues and abuse, and can put excessive emphasis on income
and financial security. The discussions within the groups
and critical examination of the definition raised a number of
questions, which need to be addressed.
The community factors that form part of the vulnerability
of a child affect all children in a community. This raises the
question of whether all children living in certain contexts
should be considered OVC. One method of addressing this
would be to look at likely exposure to the negative influences,
or whether the impact of these community factors is variable
across the community.
A clearer discussion of what is meant by vulnerability
is also required. As a starting-point it implies real risk of
long-term damage. This would include vulnerability to
infection with HIV, dropping out of school and losing out on
an education, experiencing development problems through
lack of food, or having social problems due to not being
cared for or being denied a role model. These points can
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AIDS Behav (2006) 10:619–626 625
start the discussion, but the complexity of the definition
requires more thorough debate and more inputs.
In order to be able to measure vulnerability using a sur-
vey or general data source, easily measurable criteria are
required. For this exercise two aspects of measurement have
to be considered, namely the ease or even possibility of
measurement, and the likely accuracy of the results. Con-
structs that are more easily measurable include death or de-
sertion of parents; severe chronic illness of parents; illness
of child; disability of child; poverty/income levels, includ-
ing difficulty in accessing to grants; poor housing; difficulties
in accessing services, e.g., schooling, health and social ser-
vices; and inadequate clothing. However, even here consid-
erable problems must be recognized and it may be difficult
in any situation to get full and accurate measures of these
variables.
Some of the more difficult variables to measure are emo-
tional problems; occurrence of abuse, including excessive
discipline; and substance abuse by caregivers or the child.
These are often hidden or are less tangible, and so less
open to measurement. However, their implications for the
child can be as great as or greater than those more easily
calculated, so they also have to be considered. There are
options for the use of psychometric scales or observational
research methods to collect this information.
Conclusions
This discussion provides a starting point for the construction
of a definition of OVC that can be used for the development
of interventions, and for the development of further research
to adequately understand the position of OVC. The variation
across contexts requires specific consideration, as stated un-
der “Methodology.” However, there was strong agreement
across all the sites and as to the content of this report. The
results are also similar to those obtained from research in
many other countries. It is useful to note that similar debates
and decisions around definition and support were generated
in Rwanda in discussions about assisting vulnerable children
after the genocide [19].
There are a number of immediate confusions around the
levels of need of OVC, the relative readiness of governments
to step in and assist the people in the country, and the role of
culture in responding to the situation of HIV. The influence
of these and other contextual variables on vulnerability and
on the nature of the vulnerability that the child would ex-
perience have to be considered in the ongoing development
of a construct of vulnerability. For example, if a rural com-
munity is experiencing a drought, then access to food and
water becomes core to the care of the children living there.
However, even given these needs for flexibility, it is possible
to develop an overarching set of constructs that can be used
to understand the vulnerability that children face in certain
communities.
At the basis of all of this work is the desire to address
the needs of OVC. A definition of such vulnerable children
provides a basis for understanding the range and nature of
needs that vulnerable children face. In each context, greater
specificity about needs will have to be obtained, but this is
part of the development of interventions that seek to roll
back the impact of HIV and other challenges to childhood
development.
Acknowledgements We would like to acknowledge the W.K. Kellogg
Foundation for their funding of the study and interventions, and for their
continued support of this program.
The direct contribution of the Masiela Trust in Botswana, the Family
AIDS Caring Trust in Zimbabwe and the Nelson Mandela Children’s
Fund in South Africa also need to be acknowledged for assisting in
facilitating access and for their collaboration on the overall project.
Finally, those who participated directly in the project are, particu-
larly the OVC, caregivers, NGO members, and service providers.
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