There is clearly a need for revolutionary strategies – in addition to the resources to employ them – if children affected by HIV/AIDS are not to be treated in a manner that jeopardizes their rights and contradicts accepted good practice in child care.
Such strategies must include: opposing the removal of a child from parental care only for reasons directly linked to the parents’ HIV/AIDS status; provision of sufficient resources and support to parents to enable them to continue to care for their children; provision of support to kin and others who could provide family-based care when maintenance of children with their parents is impossible; information and other campaigns to prevail over stigma; and efficient promotion of policies restricting the establishment of residential units, with the requirement that the potential resources involved be re-directed to family-based schemes (Williamson, 2004). Certainly, the existence of good standards on out-of-home care that both set basic generic principles and consist of the special situation of children affected by HIV/AIDS would represent an important tool for promoting the adoption and implementation of appropriate policies, strategies and programs. These high standards could help provide more comprehensive guidance to countries coping with the care issues which are brought about or intensified by the HIV pandemic.
The UNICEF/ISS Working Paper provides a list of issues for which internationally-agreed strategies or minimum standards do not exist and are needed, almost all of which are relevant in the context of HIV/AIDS. Those of particular importance in this regard include: – Services to be provided for keeping children in safety with their parents wherever possible; – Conditions to be met when children are to be removed from parental care; – Processes and means enabling the children concerned to have a real say in the care option chosen, and to be consulted regularly during the period in which out-of-home care is provided; – Permanency planning; – Protection in informal care situations; – Selection, training, monitoring and support for foster carers; – Recourse to, and conditions in, residential care; – Responses to child-headed households.
With the aim of responding to the particular concerns raised in this paper, both international and national standards and guidelines should also explicitly address: – The significance of provisions to prevent separation. In the case of parents or children living with HIV and other chronic illnesses – access to health care and related services – Instruments for supporting and monitoring kinship care in addition to other forms of informal foster care which can be met by a majority of countries and which help ensure greater protection for children living in such care arrangements; – Care options and legal procedures to ensure proper support for discarded children, and prevent unnecessary separation of children from their peers or other discriminatory treatment:
– Guidance on appropriate use (if any) of medical considerations in the determination to remove children from care or to isolate them within their care environment; – Guidance on the proper use of different care options, including modern options for older children, such as child-headed households and other supported, independent living arrangements; – Standards relating to inheritance and succession rights as an essential part of permanency planning. Agency-approved guidelines in this sphere are certainly useful but alone may not carry the weight needed. Standards approved at the highest international level, ensuring appropriate attention to children affected by HIV/AIDS within the generic context of out-of-home care for children, are required to maximize implementation and compliance at national level.
There should be above all the imparting of high level education in particular the divine education to all and sundry as to counter the HIV/AIDS menace to have a long and lasting effect.
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