African girl. Copyright Justyna Furmanczyk  

Strengthening open and flexible learning for increased education access in high HIV prevalence SADC countries


Annotated bibliography

Orphans and Vulnerable Children (32 documents)

AINSWORTH, M., BEEGLE, K. & KODA, G. (2005) The Impact of Adult Mortality and Parental Deaths on Primary Schooling in North-Western Tanzania. Journal of Development Studies, 41, 412-439.
Mortality of parents and other adults due to the African AIDS epidemic could reduce children's primary schooling by reducing households' ability to pay fees, raising the opportunity cost of children's time, and leaving orphaned children with guardians who care less about their education than would their parents. This study measures the impact of adult deaths and orphan status on primary school attendance and hours spent at school using a panel household survey from north-western Tanzania, an area hard-hit by the AIDS epidemic. Attendance was delayed for maternal orphans and children in poor households with a recent adult death; there was no evidence that children 7-14 dropped out of primary school due to orphan status or adult deaths. However, among children already attending, school hours were significantly lower in the months prior to an adult death in the household and seemed to recover following the death. In addition, girls sharply reduced their hours in school immediately after losing a parent. Improvements in school quality and better access to secondary education would improve outcomes for all children, including those affected by adult AIDS mortality. Beyond that, public policy needs to focus on the special schooling constraints faced by children affected by adult deaths, both in terms of increased opportunity costs of their time and the psychological impacts, with an eye to how they might be mitigated and at what cost.

BEARD, B. (2005) Orphan Care in Malawi: Current Practices. Journal of Community Health Nursing, 22, 105-115.
This paper reviews 73 programmes caring for over 100,000 vulnerable and orphaned children in Malawi. A cross-section of programmes throughout the country was visited. Three primary care strategies were found: community-based care, institutional and residential care, and self-care. The author concludes that the model of care preferred by Africans is community based because this keeps a child in a family environment in their own village and tribe. 

BEEGLE, K., DE WEERDT, J. & DERCON, S. (2006) Orphanhood and the Long-Run Impact on Children. American Journal of Agricultural Economics, 88, 1266-1272.
Childhood orphanhood is a major risk factor for poverty in adulthood, through, among other channels, shortfalls in human capital investments in children. In sub-Saharan Africa, the prevalence of orphanhood among children has been greatly exacerbated by the HIV/AIDS pandemic. Orphanhood is expected to influence health outcomes and schooling although there are multiple potential channels through which this effect may work. Obviously, income effects are a strong candidate, especially when parental deaths are associated with costs and income losses due to chronic illnesses. If households are credit constrained, then reduced incomes can result in lower investments in education. Aside from these direct wealth effects, orphanhood can be associated with an increased value of the child's time in home production (as a substitute for adult labor) which results in less schooling. There may be discrimination against orphans and favoritism toward biological children for double orphans or among single orphans who do not reside with their surviving parent (i.e., are fostered out). Beyond the financial consequences of adult deaths and the implications of a loss of parental involvement, children who become orphans may suffer trauma which, in turn, affects schooling and health outcomes. Children who lose a parent due to AIDS may be additionally stigmatized, although most work does not differentiate between causes of parent deaths, almost all of which in this study are due to illness. (Abstract by author/s)
Document available online

BICEGO, G., RUTSTEIN, S. & JOHNSON, K. (2003) Dimensions of the emerging orphan crisis in sub-Saharan Africa. Social Science & Medicine, 56, 1235-1247.
This study uses recent Demographic and Health Survey (DHS) data to examine levels, trends, and differentials in orphan prevalence in sub-Saharan Africa. The first part of the analysis presents direct estimates of orphan prevalence in 17 countries during the period 1995-2000. We find a strong correlation between orphanhood prevalence and national adult HIV prevalence estimates lending support to the interpretation of the orphan crisis as, in large part, AIDS-related. The second part of the analysis consists of an in-depth study of trends and age-patterns in orphan prevalence and welfare in the 1990s for five countries that have had widely divergent HIV prevalence levels (Zimbabwe, Kenya, Tanzania, Ghana, and Niger). The vulnerability of orphans with respect to their situation in households and educational opportunities is evaluated in relation to non-orphans' experience. The results of the analysis indicate that losing one or both parents is significantly associated with diminished chances of being at the appropriate grade level for age. Our results are interpreted in the context of societal responses to the crisis, and potential recommendations for intervention.
Document available online

BOLA, T. & CARROLL, K. (2003) Addressing the educational needs of orphans and vulnerable children. Policy and Research: Issue 2.
This paper describes the educational disadvantage faced by orphans and vulnerable children (OVCs) and summarises a number of educational responses. It aims to respond to the concern that orphaned children are dropping out of school at a higher rate than non orphaned children, and asks how it is best to meet the educational needs of these OVCs. The paper focuses on the following three responses:
- open and distance learning
- school feeding schemes
- the index for inclusion
The paper was developed by the UK working group on education and HIV/AIDS and summarises issues raised from a meeting between researchers, practitioners and policy makers in London 2003.

CASE, A. & ARDINGTON, C. (2006) The Impact of Parental Death on School Outcomes: Longitudinal Evidence from South Africa. Demography, 43, 401-420.
We analyze longitudinal data from a demographic surveillance area (DSA) in KwaZulu-Natal to examine the impact of parental death on children's outcomes. The results show significant differences in the impact of mothers' & fathers' deaths. The loss of a child's mother is a strong predictor of poor schooling outcomes. Maternal orphans are significantly less likely to be enrolled in school & have completed significantly fewer years of schooling, conditional on age, than children whose mothers are alive. Less money is spent on maternal orphans' educations, on average, conditional on enrollment. Moreover, children whose mothers have died appear to be at an educational disadvantage when compared with non-orphaned children with whom they live. We use the timing of mothers' deaths relative to children's educational shortfalls to argue that mothers' deaths have a causal effect on children's educations. The loss of a child's father is a significant correlate of poor household socioeconomic status. However, the death of a father between waves of the survey has no significant effect on subsequent asset ownership. Evidence from the South African 2001 Census suggests that the estimated effects of maternal deaths on children's outcomes in the Africa Centre DSA reflect the reality for orphans throughout South Africa. (Abstract by author/s)

CASE, A., PAXTON, C. & ABLEIDINGER, J. (2004) Orphans in Africa: Parental Death, Poverty, and School Enrollment. Demography, 41, 483-508.
We examine the impact of orphanhood on children's school enrollment in 10 sub-Saharan African countries.  Although poorer children in Africa are less likely to attend school, the lower enrollment of orphans is not accounted for solely by their poverty. We find that orphans are less likely to be enrolled than non-orphans with whom they live. Consistent with Hamilton's rule, the theory that closeness of biological ties governs altruistic behaviour, outcomes for orphans depend on the relatedness of orphans to their household heads. The lower enrollment of orphans is largely explained by the greater tendency of orphans to live with distant relatives or unrelated caregivers. (Abstract by author/s)

CLUVER, L. & GARDNER, F. (2007) Risk and protective factors for psychological well-being of children orphaned by AIDS in Cape Town: A qualitative study of children and caregivers' perspectives. AIDS Care, 19, 318-325.
This qualitative study explores perspectives of affected families. Orphaned children (n = 60), caregivers of orphaned children (n = 42) and social care professionals (n = 20) completed semi-structured interviews and focus groups. Participants were recruited from schools, shelters and welfare services. Findings from multiple sources indicate potential risk and protective factors in a range of dimensions, including bereavement, family functioning, social support, poverty, access to education and perceived stigma. Many factors reflected international literature on children experiencing similar stressors (e.g. non HIV/AIDS-related bereavement). However, this study also identified factors which may be specific to this group, notably stigma, abuse and peer factors. Current research is quantitatively testing associations between these identified factors and psychological outcomes. (Abstract by author/s)

DAVIDS, A., NKULULEKU, N., MFECANE, S., SKINNER, D. & RATELE, K. (2006) Multiple vulnerabilities: qualitative data for the study of orphans and vulnerable children in South Africa. Social Aspects of HIV/AIDS and Health Research (SAHARA) programme. Cape Town, Human Sciences Research Council.
In 2002, the Human Sciences Research Council was commissioned by the WK Kellogg Foundation to develop and implement a five-year intervention project focusing on orphans and vulnerable children (OVC) in southern Africa. In collaboration with several partner organizations, the project currently focuses on how children, families and communities in Botswana, South Africa and Zimbabwe are coping with the impact of HIV/AIDS. The aim of the project is to develop models of best practise so as to enhance and improve support structures for OVC in the southern African region as a whole. (Extract from report)

EVANS, D. K. & MIGUEL, E. (2007) Orphans and schooling in Africa: A longitudinal analysis. Demography, 44, 35-57.
AIDS deaths could have a major impact on economic development by affecting the human capital accumulation of the next generation. We estimate the impact of parent death on primary school participation using an unusual five-year panel data set of over 20,000 Kenyan children. There is a substantial decrease in school participation following a parent death and a smaller drop before the death (presumably due to pre-death morbidity). Estimated impacts are smaller in specifications without individual fixed effects, suggesting that estimates based on cross-sectional data are biased toward zero. Effects are largest for children whose mothers died and, in a novel finding, for those with low baseline academic performance. (Abstract by the author/s)
Document available online

GUNDERSEN, C., KELLY, T., JEMISON, K., EMILY, H. & BRUCE, F. (2006) Demand for Schooling among Orphans in Zimbabwe. Research in the Sociology of Education. JAI.
We examine the effect of orphan status on school enrollment in Zimbabwe, a country strongly impacted by the HIV/AIDS pandemic with a rapidly growing population of orphans. Using data from 2002, after controlling for other determinants of enrollment we find that orphans are less likely to attend school than non-orphans. Two additional results have implications for targeting: we find that the effect of being an orphan is especially large for older children and that, after controlling for previous education, the effect of being an orphan on school enrollment sharply declines. (Abstract by author/s)

GUTTMACHER INSTITUTE (2007) The special needs of orphans: the case of Malawi. Guttmacher Institute.
In the countries hardest hit by HIV and AIDS, caring for adolescents who have lost one or both parents puts an added strain on the extended family and the community. Child-headed households and child laborers are all too common, and research shows that for many children, losing a parent means losing not only the affection of a mother or father, but also food, shelter and health care. With these added pressures and limited safety nets, orphans are more likely to engage in risky behaviors and therefore face increased risk of HIV/AIDS and unintended pregnancy. Losing a parent can also mean not getting the parental care and advice about life, love and health that other young people receive. Orphans rely more heavily on public sources of information than children with both parents. If they lack access to youth-friendly health information and services, these young people are often left with nowhere to turn. (excerpt)

KIDMAN, R., PETROW, S. & HEYMANN, S. (2007) Africa's orphan crisis: Two community-based models of care. AIDS Care 19, 326-329.
The AIDS epidemic has created a crisis for children, severely threatening the health and development of children whose parents are ill, have died and whose communities have lost a large percentage of their adults. Even when extended family can serve as guardians, their need to work in the context of widespread poverty decreases the amount of time they are able to spend with children. Other children live in child-headed households or with seniors unable to provide adequate care. Relative to the size of the need there are few interventions that provide support to orphans in sub-Saharan Africa. We report on two different models of community-based care that have emerged to fill this caregiving gap, and highlight the relative advantages of each. These programmes, one centralized and the other decentralized, are an effective means of caring for orphans and could be scaled up in other communities to meet the magnitude of the crisis. (Abstract by author/s)

KIMANE, I. (2004) Update on the Situation Analysis of Orphaned and Vulnerable Children in Lesotho. Ministry of Health and Social Welfare, Lesotho Save the Children Fund, UNICEF.
The report provides an update on the situation of OVCs indicating the extent of child abuse and labour in Lesotho. It describes the breakdown of traditional practices that used to serve as safety nets for orphanhood and neediness in the country as a result of the growing vulnerability and poverty. Among other evidences of the growing vulnerability, it records the growing numbers of street children not seen at the current scale before.

LOENING-VOYSEY, H. & WILSON, T. (2001) Approaches to Caring for Children Orphaned by Aids and other Vulnerable Children: Essential elements for a quality service. Report Prepared for the United Nations Children’s Fund (UNICEF). Institute for Urban Primary Health Care (IUPHC)
Research on models of care of orphaned children in Zambia revealed a four-tier response to children’s needs in the quest for upholding their rights. These tiers include the immediate family, the extended family, the community, and the state. The child’s mother or father represents the first level of duty bearers and there are a number of responsibilities for which this prime caregiver is responsible. The extended family, community, and state have duties owed to the child too.  In terms of the International Human Rights Law the state has three obligations: to respect, to protect and to fulfill the realisation and enjoyment of rights (UNICEF, 2000). This study examines the delivery of services to orphans and vulnerable children (OVC) in South Africa within this four-tier context. The study sought to identify the policy options, assess them and look at their feasibility. Based on the findings, recommendations are made for policy development for OVC. (Abstract by author/s, abridged)

MASMAS, T. N., JENSEN, H., DA SILVA, D., HOJ, L., SANDSTROM, A. & AABY, P. (2004) The social situation of motherless children in rural and urban areas of Guinea-Bissau. Social Science & Medicine, 59, 1231-1239.
With the increasing prevalence of HIV infection and the high maternal mortality, orphans are a rapidly growing problem in Africa. However, few studies describe the social conditions of these children. Our study focuses on motherless children in urban and rural areas of Guinea-Bissau. Although orphan children remained disadvantaged, there were few differences between surviving motherless and control children in nutritional status, use of health care services, school attendance, quality of housing, and clothing. Motherless children moved more frequently and were more likely to live in small families, often with an older grandmother. The traditional extended family system appears to be capable of handling motherless children in a non-discriminatory fashion. However, the AIDS epidemic will continue to stress the extended family system and social services to the limit. (Abstract by author/s)

MCBRIDE, R. (2004) Fenced into Cycles of Deprivation: Orphans, their female carers and education in Malawi. In YEAKEY, C. C., RICHARDSON, J. W. & BUCK, J. B. (Eds.) Advances in Education in Diverse Communities: Research, Policy and Praxis. Elsevier JAI.

MEINTJES, H. & GIESE, S. (2006) Spinning the Epidemic: the making of mythologies of orphanhood in the context of AIDS. Childhood, 13, 407-429.
The objective of the study was to determine whether differences in wellbeing (defined by a variety of education and health outcomes) exist between recent school-aged orphans and non-orphans who live in the same household in a context of high HIV/AIDS mortality in KwaZulu Natal, South Africa. The authors found that no statistically significant differences in most education, health and labour outcomes between orphans and the non-orphans with whom they live. Paternal orphans are more likely to be behind in school, and recent mobility has a positive effect on schooling outcomes.
Document available online

MONASCH, R. & BOERMA, J. (2004) Orphanhood and childcare patterns in sub-Saharan Africa: an analysis of national surveys from 40 countries. AIDS 18, S55-65.
A descriptive analysis of nationally representative household surveys from 40 countries in SSA. Results showed that overall 9% of children under 15 years have lost at least one parent . On average, one in six households with children are caring for orphans. Orphans more frequently live in households that are female-headed, larger, and have a less favourable dependency ration.  The head of the household is considerably older. Child caring practices differ between countries, and between non-orphans and orphans. Based on the country medians, almost nine out of 10 non-orphans live with their mother and eight out of 10 non-orphans live with their father. Single orphans are less likely to live with their surviving parent: three out of four paternal orphans live with their mother and just over half of maternal orphans live with their father. The (extended) family takes care of over 90% of the double orphans. Orphans are approximately 13% less likely to attend school than non-orphans. Double orphans are most likely to be disadvantaged. The researchers conclude that the epidemic has caused rapid and recent increases in the prevalence of orphanhood. Prevailing childcare patterns have dealt with large numbers oforphans in the past, and to date there is no consistent evidence that this system is not absorbing the increase in orphans on a large scale. Yet, there is some evidence that orphans as a group are especially vulnerable, as they live in households with less favourable demographic characteristics and have lower school attendance.

MUULA, S. A., MISIRI, H., L., M., KALENGO, S., KACHALI, F., MBEWE, M. & MSUKU, S. (2003) The living situations of orphans in periurban Blantyre, Malawi. South African Medical Journal, 93, 920-921.
Reports on a qualitative study in peri-urban Blantyre of the living situation of orphans living in 157 households. Despite the fact that primary education is free in Malawi, money was cited as a common reason why some orphan children were not attending schools. Property grabbing was identified as of particular concern with up to one fifth of the household having experienced it.  

NYAMBEDHA, E. O., WANDIBBA, S. & AAGAARD-HANSEN, J. (2003) Changing patterns of orphan care due to the HIV epidemic in western Kenya. Social Science & Medicine, 57, 301-311.
The HIV/AIDS epidemic has given rise to major demographic changes including an alarming number of orphans in sub-Saharan Africa. The study describes a rural community in western Kenya in which one out of three children below 18 years of age had lost at least one biological parent—and one out of nine had lost both. The main problems these children faced were lack of school fees, food and access to medical care. The high number of orphans has overwhelmed the traditional mechanisms for orphan care, which were based on patrilineal kinship ties. Thus, 28% of the orphans were looked after by culturally “inappropriate” categories such as matrilineal kin or strangers. Furthermore, many of the caretakers were themselves not capable due to ill health or old age. Factors such as poverty, negative attitudes, and traditional funeral customs made the orphans’ situation even worse. The authors conclude that though community-based interventions are urgently needed as the most appropriate way to address the issue, the complex, local reality in which cultural factors, kinship ties, and poverty are interwoven needs to be taken into consideration if sustainable solutions are to be found. (Abstract by author/s)

ROBSON, S. & SYLVESTER, K. B. (2007) Orphaned and vulnerable children in Zambia: the impact of HIV/AIDS epidemic on basic education for children at risk. Educational Research, 49, 259-272.
This study explored staff and student perceptions of the impact of the HIV/AIDS epidemic on the education of affected children in high-prevalence districts of the Copperbelt province of Zambia. The impact of the epidemic on student enrolment, attendance and completion rates, and on the quality of the learning experience, was investigated. The study provides information on the impact of the epidemic on basic education that has not previously been documented in Zambia and may assist the strategic planning and management of basic schools. A positive outcome of this study was that students, teachers and other professionals freely discussed issues concerning HIV/AIDS and its impact on education in a context where such issues are usually met with silence or denial. (Abstract an extract from the paper)

RULAND, C. D., FINGER, W., WILLIAMSON, N., TAHIR, S., SAVARIAD, S., SCHEITZER, A. M. & SHEARS, K. H. (2005) Adolescents: Orphaned and Vulnerable in the time of HIV/AIDS: Youth Issue paper 6
Young people who have lost one or both parents multifaceted needs, particularly in the era of AIDS. Adolescent orphans require different kinds of assistance than children; in some ways their needs are more complex than the needs of younger orphans because of physical and psychological development during puberty and the steps needed to move toward independence and adulthood. Worldwide, the number of orphans would be decreasing except for AIDS. About eight of every 10 of those orphaned due to AIDS live in Africa. Perhaps the most important statistic for this paper is the fact that an estimated 55 percent of all orphans under age 18 are adolescents. (Abstract by author/s)

SAVE THE CHILDREN (2007) Children at the centre: A guide to supporting community groups caring for vulnerable children. London, Save the Children.
Governments, donors and NGOs increasingly see community mobilisation as important in the care and protection of vulnerable children. Such responses are becoming more and more frequent as families in developing countries struggle to cope with the impact of the HIV pandemic, chronic poverty and recent conflict. "Children at the Center" is a guide to how agencies and organisations can support the establishment of community groups to care for and protect vulnerable children. It draws directly on the experience of children, members of community groups, NGOs and others. (Abstract by author/s)

SHARMA, M. P. (2006) Orphanhood and Schooling Outcomes in Malawi. American Journal of Agricultural Economics, 88, 1273-1278.
This article was presented in a principal paper session at the AAEA annual meeting (Long Beach, CA, July 2006). The articles in these sessions are not subjected to the journal's standard refereeing process.

SKINNER, D., DAVIDS, A., MATLHAKU, T., PHAKEDI, R., MOHAPELOA, P., ROMAO, S., MDWABA, T., KAZI, N. & MUNDONDO, J. (2006) Working to Support Orphans and Vulnerable Children in Southern Africa. A Reflection on Values, Principles and Organisational Issues. Cape Town, HSRC Press.
In 2002, the Human Sciences Research Council was commissioned by the WK Kellogg Foundation to develop and implement a five-year intervention project focusing on orphans and vulnerable children (OVC) in southern Africa. In collaboration with several partner organizations, the project currently focuses on how children, families and communities in Botswana, South Africa and Zimbabwe are coping with the impact of HIV/AIDS. The aim of the project is to develop models of best practise so as to enhance and improve support structures for OVC in the southern African region as a whole.

SKINNER, D., TSHEKO, N., MTERO-MUNYATI, S., SEGWABE, M., CHIBATAMOTO, P., MFECANE, S., CHANDIWANA, B., NKOMO, N., TLOU, S. & CHITIYO, G. (2006) Towards a Definition of Orphaned and Vulnerable Children AIDS and Behavior, 10, 619-626(8).
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 accurate definition. Twelve focus group interviews of service providers, leaders in these communities, OVC and their caretakers 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 vulnerability included severe chronic illness of a parent or caregiver, poverty, hunger, lack of access to services, inadequate clothing or shelter, overcrowding, deficient caretakers, and factors specific to the child, including disability, direct experience 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.

WFP (2003) HIV/AIDS & Children: Bringing hope to a generation. Food aid to help orphans and other vulnerable children. Rome, WFP.
The World Food Programme (WFP) is helping to secure the safety and well-being of orphans and other vulnerable children. WFP’s nutritional support to children and their parents brings hope into lives made uncertain by the disease. The nutritious food helps keep HIV-positive parents alive longer, giving them more time with their children. Targeted food assistance also enables vulnerable children to get an education and build skills for the future. WFP food is meeting today’s hunger needs as well as contributing to a better tomorrow. (Abstract by author/s)
Document available online

UNICEF (2006) Africa's orphaned and vulnerable generations: Children affected by AIDS. New York, UNICEF.
Africa's Orphaned and Vulnerable Generations: Children affected by AIDS shows how the AIDS epidemic continues to affect children disproportionately and in many harmful ways, making them more vulnerable than other children, leaving many of them orphaned and threatening their survival. Released by UNICEF, UNAIDS and PEPFAR (The US President's Emergency Program for AIDS Relief), the report contains new and improved research on orphans and vulnerable children, including what governments, NGO's, the private sector and the international community can do to better respond. This pre-publication document has been prepared to facilitate the exchange of knowledge and stimulate discussion; the final publication is forthcoming.
Document available online

UNICEF (2004) The framework for the protection, care and support of orphans and vulnerable children living in a world with HIV and AIDS. New York, UNICEF.
This report is a framework that is based on lessons learned over many years on possible interventions meant to alleviate the negative impact of HIV/AIDS on the affected and infected children. The framework is based on five key strategies: strengthening the capacity of families to protect and care for orphans and vulnerable children, mobolising and supporting community-based responses, ensuring access for orphans and vulnerable children to essential services including education, ensuring that governments protect the most vulnerable children through positive policies and legislation, and raising awareness at all levels through advocacy and social mobilisation. (Abstract by author/s)
Document available online

YAMANO, T., YASUHARU, S. & SSERUNKUUMA, D. (2006) Living arrangements and Schooling of Orphaned Children and Adolescents in Uganda. Economic Development and Cultural Change, 54, 833-856.

This article estimates the determinants of the living arrangements and school enrollment of orphans in Uganda. The results indicate that orphans, those who have lost at least one biological parent, are more likely to be found in female-headed households than male-headed households. As the education of the female members, the number of female elders, and the value of assets increase, the probability of living with orphans who are not the biological children of any of the household members also increases. In addition, we find that female adolescents aged 15-18 are significantly less likely to be enrolled in secondary school and exhibit slow progress in grade school advancement if they are either double orphans or single orphans who are not living with their remaining parent. Among children aged 7-14, however, we do not find any differences in school enrollment between orphans and nonorphans. (Abstract by author/s)

WOOD, K., CHASE, E. & AGGLETON, P. (2006) 'Telling the truth is the best thing': Teenage orphan's experiences of parental AIDS-related illness and bereavement in Zimbabwe. Social Science and Medicine, 63, 1923-1933.
Zimbabwe is one of the countries most affected by HIV/AIDS, and as elsewhere in southern Africa, the impact on children and young people living in affected households is significant. Loss is highly complex and dependent on developmental stage, resilience, quality of care, and social support networks, and often includes a progression of experiences from the onset of a parent's or caregiver's illness, through to the aftermath of death. For several reasons, AIDS-related bereavement is likely to be especially complicated and difficult to accommodate. Understandings of bereavement and grief among African children, and adults’ responses to orphans’ psychological difficulties, remain under-developed. This paper focuses on the narratives of older children in their teens, who have experienced parental AIDS-related illness and death in six sites in Zimbabwe. A key finding is that, while many orphaned teenagers desire direct communication with adults about parental illness and death, adults themselves—whether the sick parent, other relatives in the household or a caregiver following parental loss—are often ill-equipped to identify and manage children's distress positively. While most existing psychosocial interventions focus on bereaved children, this paper suggests that, in order to create an enabling environment for orphans, building the capacity of key adults in orphans’ lives, particularly surviving relatives, caregivers, and teachers to address emotional issues relating to parental loss constructively is an essential, but neglected, area of programming. (Abstract by author/s)


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