Review of Prevalence and Characteristics of AIDS Orphans in Ethiopia


By


Gebrehiwot Hailemariam

Tigray Agricultural Research Institute

P. O. BOX 492

Email: gbiru2000@yahoo.com


Table of content
1. Background justification 3
2. Review of results 4
2.1. The prevalence of AIDS orphan 4
2.2. Socio-economic status of AIDS orphaned households 5
2.2.1. Custody of AIDS orphans 5
2.3. Status of AIDS orphan children 6
2.3.1. Meeting basic needs-Food 6
2.3.2. Closing 7
2.3.3. Education 7
2.3.4. Health status 7
2.3.5. communities responses to AIDS orphans 8
2.3.6. Economic activity 8
3) Conclusion 10
4) References 12


1. Background justification
The rate of HIV infection is growing at a faster rate. Globally around 42 million people are living with HIV/AIDS as of December 2002, out of which 95 % are living in developing countries (UNAIDS, 2002) . That is out of the total 42 million people living with HIV, 95% are said to be living in the developing world and among these 71% are found in sub-Saharan Africa. The rate at which the pandemic is increasing is also much higher in this region. In Sub-Saharan Africa, Ethiopia is among the counties that are highly affected by the pandemic.
The country, with 3.6 million people living with HIV/AIDS, is third in terms of absolute number of HIV/AIDS infected people, following India and South Africa (MOH, 2002).
This has an important implication for development. Recent studies showed that the prevalence rate of the epidemic is 13.7 % in urban areas and 3.7% in rural areas with an average rate of 6.3% (MOH, 2002). Though the prevalence rate seems to be smaller in rural areas, there is an expectation that the trend would be higher in the years to come. This is mainly because the driving forces of HIV/AIDS transmission namely poverty, illiteracy, access to public services like health services… - are currently higher in the rural areas than in the urban (MOH , 2002).

The highest urban prevalence rates in Ethiopia are Bahir Dar (23.4 %), Jijiga (19 %,) Nazreth (18.7%), Mekele (17.2%), Maichew (16.8%), Adigrat (16.2%), Addis Ababa (15.6%) and Dire Dawa 15.2%) (MOH, 2002) .
This high HIV/AIDS prevalence has economic, social and demographic consequences, among others, it leaves vast number of orphaned children. The number of AIDS orphan children are raising from tome to time and it is expected to increase in years to come. Despite the magnitude and severe consequences of the pandemic, data on prevalence and situation of AIDS orphan is lacking. The information on the magnitude and socio-economic conditions of AIDS orphans will have a greater contribution for governmental, community-based and non-governmental organisations to address the problems of and develop appropriate programs for the AIDS orphans. Hence, this paper will review the prevalence and situation AIDS orphans in Ethiopia based on the findings of previous researches mainly MOLSA (2002).
2. Review of results
2.1. The prevalence of AIDS orphan
The number of orphans has increased over time. There are about 108 million orphans from all causes in Africa, Asia, Latin America and the Caribbean, which makes up about 7.4% of all children in the region, the percentage that was orphaned by AIDS is 12%. According to a joint report released by USAIDS, UNICEF and UNAIDS, currently more than 13 million children have lost one or both parents to AIDS. Sub-Saharan Africa bears by far the highest burden: about 12% of the total children in the region as compared to 6.5% in Asia and 5% in Latin America and the Caribbean (Children on the Brink, 2002) . The study showed that AIDS orphans are concentrated in 12 Sub-Saharan Countries, and a higher concentration was observed in those countries with the largest population. Accordingly Nigeria, Ethiopia and Democratic Republic of Congo had the most orphans. Studies have shown that AIDS orphans represent about 47 % of the total orphans in Ethiopia. This figure is very high compared to the figure mentioned above at regional level. According to MOLSA the prevalent rate of AIDS orphan in the total child population in major cities, small towns and rural areas are estimated to be 14.6%, 16.67% and 14.77 % respectively, with an average national rate of 14.87% (MOLSA). This indicates that there are a total population of 4, 394,652 AIDS orphan population in the country. There is no significant difference among the three strata. This finding is contrary to the popular expectation that AIDS orphan hood would decrease as one goes from major cities to rural areas with the assumption that HIV infection is relatively higher in the urban areas, and the prevalence of AIDS orphan is positively correlated with HIV infection. However, a number of studies indicated that the AIDS orphans prevalence of urban and rural areas is relatively comparable (FAO and UNAIDS 1999, Save the children 2002, MOLSA 2002 and ROPCA , 2002).
Of the total AIDS orphans, 48.85 % are male and the remaining 51.15 % are female. As to the age distribution of AIDS orphans, more than half (55.79 %) was below ten years of age and the remaining 44.21 % are between 10 to 18.

2.2. Socio-economic status of AIDS orphaned households

2.2.1. Custody of AIDS orphans
According to the survey conducted by MOLSA the majority of AIDS orphans (73.98%) live with their families, while the rest with relatives, neighbours, friends, alone and as servants (figure 1).

Source: MOLSA, 2002.
Educational status of the household head of the AIDS orphan families: 36.8% of household head are illiterate, while the rest are literate, with their education levels ranging from adult education to 12 grade. Only 0.9% of the household head has attained some kind of training at higher institute.

Family income of AIDS orphan households:
A study conducted in the Tigray regional state have shown that the majority of AIDS orphan households (77.8%) do not have any source of monthly income they can name as such, while the rest have monthly incomes ranging from 2.5 to 35 USD (ROPCA, 2002). At national level, 63.2% of the households of the AIDS orphan earn a monthly income of less than 12.00 USD and about 5.7 % of AIDS orphan households earn a monthly income of more than 60.00 USD. This figure is low compared to the non-AIDS orphans.
In general the socio-economic status of AIDS orphan families are characterised by high illiteracy rates of heads of households, low family income and lack of facilities like access to drinking water, health service, radio, TV set etc.

2.3. Status of AIDS orphan children

2.3.1. Meeting basic needs-Food
Securing daily food is among the major problem for most AIDS orphans. According to the study conducted by MOLSA about 50% of the AIDS orphans do not well-fed. This figure is significantly high compared to the non-AIDS orphans (40%). The possible explanation for the variation across the two groups is that the probability of AIDS orphans of losing both parents is much higher than the non-AIDS orphans. Participants of focused group discussion also reached an agreement that AIDS orphans do not get well-balanced and sufficient food. This has pushed the AIDS orphans in to various unhealthy mechanisms like beggary, working in bars, as house servants, collecting firewood, migration to other places, theft, prostitution, etc…
AIDS orphans have problem to get community/social support and networks compared to non-AIDS orphans, due to the stigma attached to HIV/AIDS, which makes them an easy target for aggravated poverty and shortage of food.
This is supported by the study that 6.1% of the AIDS orphans were forced to beg while the proportion on non-AIDS orphans that resorted to beg were 2%.
2.3.2. Closing
Closing is another problem faced by AIDS orphans. The problem of having adequate closing affects not only physically and in terms of its impacts on their health but also on their educational development. According to MOLSA, more than 55.3 % of AIDS orphans have a difficulty in getting proper closing.
2.3.3. Education
Education is another indication of AIDS orphan children. AIDS orphans are forced to drop out of schools after the death of their parents mainly for economic reasons. They are constrained by the luck of money for buying the necessary school supplies and uniforms. More over, they can work in the field to replace the labour shortage in the household like taking care of animals, collecting firewood, and fetching water. For example, in the above study, about 11.9 % of the children who was attending primary school before the death of their mother were forced to drop-out from their school after the death of their mother mainly due to due to the in-ability to buy uniforms, pay school fees and other school supplies.

2.3.4. Health status
Health is another indicator of the situation of the AIDS orphans. The health statuses of the AIDS orphans are also affected as compared to the non-AIDS orphans. For example, according to a study conducted by MOLSA to identify the occurrence of sickness during two weeks preceding the interview, has shown that 52.6% of the male and 47.4% of female AIDS orphans children below the age of ten were sick. Where as 19.1% of the non-AIDS orphan were sick during the same period.
Similarly, 16.7% of the AIDS orphans and 14.9% of the non-AIDS orphans above ten had been sick for more than a month.
The study also showed that more than two third of the sick AIDS orphans have not tried to get any medical assistance.
2.3.5. communities responses to AIDS orphans
One of the most recurring problems with AIDS orphan children was the attitude of the community towards them. Relatives and neighbours avoid them and some times prohibit their children from mixing or playing with them, and hence, they become socially isolated. In relation to this statements that some AIDS orphan children said are (from MOLSA):
“After the funeral of my mother all my relatives did not show up at all”
“After my mothers’ death, all my relatives never come back to see me and we have become burden to our neighbours”
“When my mother died, both relative and neighbours ignored me”
2.3.6. Economic activity
Child exploitation or engagement in economic activity is another problem of the AIDS orphan children. This is another, commonly observed, form of maltreatment of AIDS orphan children. The engagement of economic activity before and after the death of their children’s mother is indicated in figure two.
The most common economic activities that the AIDS orphan children are engaged in are working as daily labourer, home servant, selling “Qollo”, shoe repair and polish, petty trade, herding animal, and the like.






3. Conclusion
The prevalence of AIDS orphans in major cities, small towns and rural areas are 14. 69%, 16.67% and 14.77 % respectively. This implies that though the prevalence of HIV/AIDS is high in the urban areas as compared to the rural areas, the prevalence of AIDS orphans is equally important in all strata.

The national prevalence of AIDS orphans is 15.6% showing that a significant section of the child population is severely affected by the pandemic. A considerable amount of AIDS orphans are living outside their familial environment and are faced with environmental, physical and social hazards. They are unable to sustain their life o r expelled from their parental residences following the death of their parents resort to live with relatives, friends neighbors, alone by them selves, get hired as a servant and the like making them vulnerable to lack of familial care, love, affection and follow up. The AIDS orphan children live in families that are relatively poor in their educational level, which has a determinant effect on on the overall development of the children. Similarly the majority of AIDS orphan children live in a household with lower incomes, which is beyond their means to provide for the physical, educational and health level etc…of the children.
AIDS orphans are inadequately fed and find it difficult to get their daily food . owing to this difficulty they are involved in unhealthy, and in some cases self-abusive, destructive and anti-social copying mechanisms, including theft, begging, prostitution, economic activities, etc.
AIDS orphans are also inadequately closed implying that they are exposed to physical and environmental hazards.
The death of parents due to AIDS significantly affects the educational development and health conditions of AIDS orphan children.
Owing to the existing bias towards HIV/AIDS, The social interaction of AIDS orphan children is limited. Moreover, due to their difficulty and inability of caretakers to support them, a considerable amount of AIDS orphans are engaged in economic activities.
A number of studies has indicated that the availability and accessibility to services and institutional capacities are limited or scattered in limited pocket areas. Services, that are made available, are in short of capacitiesinlight of the magnitude of the problem of AIDS orphans. Some of the problems sited in relation to problem of capacities are lack of:
• Relevant strategies/action plans;
• information;
• sustainability of programs;
• co-ordination among parties that are working with AIDS orphan children;
• financial capacities; and
• Technical capacities at communities and organisational level.
If this is the case, what should be done to mitigate the impact of the pandemic on AIDS orphans at policy materials and strategies, advocacy, institutional, organizational, community and family level is, therefore, expected as an outcome from the workshop.


4. References