Before the initiation of the survey, MAAP needed to have baseline information on the current situation of OVC in Kajiado District and particular areas of focus, especially in the areas occupied by the Maasai community. However, there was very scanty information available on these areas. Specific key information requirements included that on; the ECD-HIV/AIDS policy environment, HIV/AIDS impact, response and resource frameworks, general demographic and social economic factors related to, or contributing to the current state of OVC especially those still in their early childhood development age (0-8 years). There was therefore need to assess the current knowledge, skills and practices compared to generally accepted best practices on OVC and identify the gaps therein.

The baseline survey has validated the pre-survey assumption that the needs of OVC in Isinya, Central, Mashuru, Magadi and Ngong areas of Kajiado District are extensive, with hardly 30% of the OVC in the early years of their development, receiving proper care and support due to acute poverty, inadequate proper information and HIV/AIDS prevention and control skills in the community. It is true that there is wide spread poverty, inadequate community resources and absence of HIV/AIDS impacts coping mechanisms; especially in capacity and resource poor localities of the district.

The survey has established that the need for a comprehensive and sustainable OVC response in the district, and especially in the pastoral Maasai community localities is indeed enormous due to; high prevalence of HIV (estimated to be above 10%), increasing poverty levels, with 74% of the community living on less than a dollar a day, very little capacity for HIV/AIDS prevention and care of the PLWHA; only about 14% of those interviewed having had some kind of information and only one person said they received a certificate in VCT training!

The main issue at hand, the increase in OVC was estimated as above average and currently stands at 23, 460 with 81% (19,003) directly attributable to AIDS. The estimated total number of OVC constitutes about 19.73% of all children aged between 0-8 years. This situation needs to be addressed urgently, adequately and strategically; with initiatives that are relevant and sustainable.

This report presents the findings of the OVC baseline survey including;

i) An overview of the relevant policies currently in place in Kenya and the possible best ways of working with the relevant government institutions on children in the district

ii) The current state of the HIV/AIDS epidemic in Kajiado district, especially the impacts on orphans and children made vulnerable by AIDS, including key relevant statistics on OVC

iii) The organizations, community resources and networks that are currently active in OVC interventions in the Maasai areas of Kajiado district.

iv) The presence of public, community, household and individual OVC coping responses in target areas of Kajiado district including an analysis of the effectiveness and sufficiency of these mechanisms.

v) The priority geographic and programmatic areas and issues that must be addressed in the design and implementation of the comprehensive OVC Programme.

vi) Key recommendations based on the findings of the survey for setting up an effective, participatory and sustainable OVC programme in the district.

The findings take a firm position that though HIV/AIDS is quietly creating lots of negative impacts within the Maasai community including the creation of an increasing number of OVC becoming the biggest problem of the scourge, there is hope. Hope that some of the traditional coping mechanisms employed by the community can be tapped to bring about a much better outcome in regard to the care and support of these OVC.

Hope that, with timely assistance from the GoK and strategic partners like BVLF, the situation will not only be improved but can be turned around within the next five years.

The findings of the survey and the lessons learnt will not only be valuable for the planned OVC programme but also for the other projects being implemented by MAAP viz; integrated poverty reduction project, development education, etc.

MAAP should consider all the key factors affected OVC, their guardians, the extended family and the local communities as well as the recommendations made in this report in the Planning, design, implementation, monitoring and evaluation of the anticipated OVC programme.

It is apparent that MAAP has the opportunity of becoming the main authority in all matters related to OVC and ECD in Kajiado district. Being a noble investment with far, lifelong benefits, the organization needs to attract more resources, promote higher networking and partnership as well do documentation in matters related to children, especially documenting traditional care and stimulation activities.

The report will help in planning, implementation, monitoring and evaluation of the proposed programme. Other partners should be encouraged to conduct other HIV/AIDS related surveys and full length research that can scientifically verify the magnitude of a problem, a situation or painting of a general picture that will add and enrich the findings of this survey.

MAAP strategy of re-engineering her programmes to include working with, and for children is an excellent strategic decision whose results are eternal as they are transferred from generation to generation. A child who goes through ECD, for example, grows up in a prudent way and this is transferred to his/her offspring and the cycle is unstoppable!

Acronyms and Abbreviations

AIDS Acquired Immune Deficiency Syndrome

AMREF African Medical Research Foundation

ART Anti-retroviral therapy

ARVS Anti-retroviral Drugs

BCC Behavioral change communication

BVLF Bernard Vern Leer Foundation

CBO Community-based organization

CCF Christian Children Fund

CSO Civil Society Organization

CSSC The Civil Society Steering Committee

ECD Early child development

ECD- Early Childhood Development

Emanyatta A Maasai temporary settlement village used for ceremonial purposes

Eunoto A Maasai warriors ‘shaving’ ceremony signifying entrance into junior eldership

FG Q Focus Group Questionnaire

GCN Girl Child Network,

GoK Government of Kenya

GTZ- German Development service

HIV Human immunodeficiency virus

HIV Human Immuno deficiency Virus

IEC Information, education, communication

IEC Information Education Communication

IQ Individual Questionnaire

Isinya one of the five divisions in Kajiado district of Kenya

KEQ, Key Informant

KNASP Kenya National AIDS strategic Plan of 2000 to 2005

M&E Monitoring and Evaluation

MAAP Maa AIDS Awareness Programme.

Magadi – one of the five divisions in Kajiado district of Kenya

Mashuru – one of the five divisions in Kajiado district of Kenya

MTCT Mother-to-child transmission

NACC - National Aids Control Council

NASCOP National AIDS and STI control programme

NGO Non-governmental organization

NGO Non-Governmental Organization

Ngong – one of the five divisions in Kajiado district of Kenya

Olng’esher One of the Maasai Junior eldership graduation ceremony

OVC Orphans and other vulnerable children

OVC orphan and vulnerable children

PLWHA People living with HIV/AIDS

PLWHAs Person living with HIV/AIDS

PMTCT Prevention of mother-to-child transmission

SO Q service organization Questionnaire

TB Tuberculosis

TBAs, Traditional Birth Attendant

TOR Terms of Reference

TOT Training of trainers

UNAIDS Joint United Nations Program on HIV/AIDS

UNAIDS United Nations Joint Programme on AIDS

UNICEF United Nations Children’s Fund

UNICEF United Nations Children Fund

USAID United States Agency for International Development

VCT Voluntary Counseling and Testing

1. BACKGROUND INFORMATION

1.1. The General Scenario:

“HIV/AIDS has been identified as the leading cause of orphaning in Sub-Sahara Africa, which is home to 12.3 million children orphaned by the disease. Other children made vulnerable by HIV/AIDS include those who have an ill parent, are in poor households that have taken in orphans, are discriminated against because of a family member’s HIV status, or who have HIV themselves. In Kenya alone, the number of orphans is expected to rise to 1.9 million in the next six years, from the current 1.7 million orphans.”[1]

As at December 2003, an estimated 1,700,000 children in Kenya had been orphaned due to HIV/AIDS with over 2 million people living with the scourge. Although prevalence rates are reducing from an alarming 15% (2000) within the general population to about 9%, (2003), the situation is still at an alarming and crisis level.

Among the countries worst hit by HIV/AIDS, only Nigeria and South Africa have more OVC than Kenya. In Kenya, about one in every 3 children orphaned by HIV/AIDS is under age five (CDC) and the fact is that when a family member has AIDS, average income in the family falls by 52 to 67 percent, while expenditures on health care quadruple. Table 1 below shows some key indicators of the children in Kenya within the ECD age bracket (0-8 years):

These survey results are based on this horrifying background on the lives of children. Maa AIDS Awareness Programme in Kenya, Kajiado district, initiated this survey to establish the extent of the myriads of problems facing orphans and vulnerable children and their families within the Maasai community in the district and come up with informed strategies for developing a response programme that will paint a future with hope for these children.

1.2. The Organization:

Maa AIDS Awareness Program (MAAP) is a local NGO, founded in 1995 and registered as an NGO in 1996. It started its activities in 1998. The fundamental goal of the organization is to reduce the spread of HIV/AIDS within Isinya Division of Kajiado district and in the entire district and also to address key developmental issues that pre-dispose the community to high rates of HIV. It also seeks to building capacity for the participation of the community in their own development. MAAP has been involved in HIV/AIDS prevention and community development activities in Kajiado District since its inception with emphasis on empowering the community through capacity building. MAAP is committed to the development of the target community as articulated in its organizational vision, mission and goal.

However, with the coming of the scourge of HIV/AIDS and parallel changing socio-economic fortunes, children within the Maasai community are increasingly becoming orphans and vulnerable due to the increasing and devastating effects of the epidemic. Presently and in the recent past, it has been MAAP’s major concern that very scanty information is available on children, ECD and the impact of HIV/AIDS on children in general within its areas. This led to the organization re-strategizing her approaches and focusing on the effects of this scourge on the lives of children.

MAAP embarked on a partnership and resource mobilization initiative that led to the Bernard Van Leer Foundation partnering with her to address the plight of these young children through an orphans and vulnerable children project, the Kajiado OVC project. Initially, the OVC project is on a one-year planning grant to mount a significant effort to mitigate the impact of HIV/AIDS on Orphans and Vulnerable Children in Kajiado District, Kenya and to mobilize the community to step up efforts in the care of orphans and vulnerable children. It is expected that this will ultimately lead to a full partnership with Bernard Van Leer Foundation, the Government of Kenya, the community and other willing partners.

1.3. The Baseline survey

A baseline survey, to scientifically verify the magnitude of the problem within Kajiado district, was initiated as a first line defense mechanism and for enhancing authoritative statistical based baseline information. This was to also help the partners to understand the peoples’ perceptions on the effects and recommend old and new mitigation mechanisms that exist or used to exist within the traditional and cultural set up of the Maasai people. It also explores traditional child rearing practices and how that can be adopted and strengthened through an enhanced early childhood development (ECD) project.

1.4. Research Problem

Before the initiation of the survey, MAAP desired to have baseline information on the current situation of OVC in Kajiado District and particular areas of focus, especially in the areas occupied by the Maasai community. Specific key information requirements included that on; the ECD-HIV/AIDS policy environment, HIV/AIDS impact, response and resource frameworks, general demographic and social economic factors related to, or contributing to the current state of OVC especially those still in their early childhood development age (0-8 years).

Although MAAP wants to particularly look into the situation of OVC in the district, including challenges facing absolute orphans, their families and caregivers, ECD programs and other community based HIV/AIDS services and programmes, very scanty information is available on these areas.

There was therefore need to assess the current knowledge, skills and practices compared to generally accepted best practices on OVC and identify the gaps therein. MAAP had the challenge of identifying geographic and programmatic priorities on ECD and OVC in order to undertake sustainable OVC care and support actions within the OVC project.

There was need make specific recommendations required to facilitate the process of planning strategic and integrated collaborative responses that successfully address the needs of orphans and children made vulnerable by HIV/AIDS within the Maasai community of Kajiado district. Finally, MAAP is expected to use these survey findings and recommendations to fill the identified information gaps and primarily for designing and implementing an appropriate programme on OVC in the target district from the second phase of the project onwards.

1.5. Hypothesis

MAAP held the assumption that the needs of OVC in Isinya, Central, Mashuru, Magadi and Ngong areas of Kajiado District are extensive, with hardly 30% of the OVC in the early years of their development, receiving proper care and support due to acute poverty, inadequate proper information and HIV/AIDS prevention and control skills in the community. Other key factors observed during MAAP’s 6 years of HIV/AIDS prevention and control work in the district include; inadequate community resources and absence of coping mechanisms; especially in capacity and resource poor localities of the district.

The organization strongly believed that there is need for a comprehensive and sustainable OVC response in the district, and especially in the pastoral Maasai community localities is enormous due to the above factors and needed to be addressed urgently, adequately and strategically; with initiatives that are relevant and sustainable

2. SURVEY JUSTIFICATION

2.1. Rationale for the Survey:

With the outcome of the survey, MAAP will be able to authoritatively carry out its mandate of mobilizing the community and other key stakeholders to reach and provide sustainable care and support and a conducive environment for the holistic development of to young children aged between 0-8 years within the Maasai community areas of Kajiado district and in the long run, other Maasai districts in Kenya and Tanzania.

Having identified OVC programming as a key need in the district, MAAP will then seek to better understand the magnitude of the need, the number of children and community adult members affected, current practices and what should be done to provide a better and effective response that shall result in significant positive impact for the beneficiaries.

The aim of the study was to fill the existing information gaps in OVC programming in the target district and result in information that shall be instrumental in assessing, planning, designing, implementing, monitoring and evaluating a comprehensive and sustainable OVC programme. Establish the current status of the HIV/AIDS in Kajiado district, including relevant statistics (prevalence rate, OVC population segregated by gender and age, school attendance, factors influencing drop out) and what various stakeholders are doing to cope with the situation. The main output of the survey was to analyze and present the current HIV/AIDS and OVC policies in place in Kenya and give a situational analysis on OVC that will assist in programming decisions.

It was expected to make recommendation for organizing a strong network of current and potential organizations focusing on mitigating the impacts of the scourge on OVC in the district. This will enhance a platform for exchanging ideas and experiences between the participating stakeholders.

2.2. The objectives of the survey:

vii) Identify relevant policies currently place in Kenya and the best way of working with the relevant government institutions on children in the district

viii) Establish the current state of the epidemic in Kajiado district, especially the impacts on orphans and children made vulnerable by AIDS, including key relevant statistics on OVC

ix) Identify organizations, community resources and networks that are currently active in OVC interventions in the Maasai areas of Kajiado district.

x) Identify the presence, effectiveness and sufficiency of public, community, household and individual OVC coping responses in target areas of Kajiado district

xii) Make key recommendations based on the findings of the survey for setting up an effective, participatory and sustainable OVC programme in the district.

2.3. Scope Of The Study

In order to achieve the overall objective of the survey, the following set of activities were planned and duly executed;