A census of orphans and vulnerable children in two Zimbabwean districts Shungu Munyati, Simbarashe Rusakaniko, Pakuromhunu F Mupambireyi, Stanford T Mahati, Peter Chibatamoto, & Brian Chandiwana Edited by Shungu Munyati NATIONAL INSTITUTE OF HEALTH RESEARCH, M INISTRY OF HEALTH A ND CHILD WELFARE BIOMEDICAL R ESEARCH & T RAINING I NSTITUTE Free download from www.hsrcpress.ac.za Prepared by the Biomedical Research and Training Institute (BRTI) and the National Institute of Health Research (NIHR) of the Ministry of Health and Child Welfare, Harare, Zimbabwe. Published by HSRC Press Private Bag X9182, Cape Town, 8000, South Africa www.hsrcpress.ac.za © 2006 HSRC, BRTI, NIHR & FACT First published 2006 All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. ISBN 0 7969 2146 6 Print management by comPress Distributed in Africa by Blue Weaver PO Box 30370, Tokai, Cape Town, 7966, South Africa Tel: +27 (0) 21 701 4477 Fax: +27 (0) 21 701 7302 email: orders@blueweaver.co.za www.oneworldbooks.com Distributed in Europe and the United Kingdom by Eurospan Distribution Services (EDS) 3 Henrietta Street, Covent Garden, London, WC2E 8LU, United Kingdom Tel: +44 (0) 20 7240 0856 Fax: +44 (0) 20 7379 0609 email: orders@edspubs.co.uk www.eurospanonline.com Distributed in North America by Independent Publishers Group (IPG) Order Department, 814 North Franklin Street, Chicago, IL 60610, USA Call toll-free: (800) 888 4741 All other enquiries: +1 (312) 337 0747 Fax: +1 (312) 337 5985 email: frontdesk@ipgbook.com www.ipgbook.com Free download from www.hsrcpress.ac.za iii ‘Religion that is pure and undefiled before God, the Father, is this: to care for orphans … in their distress.’ James 1 verse 27 Free download from www.hsrcpress.ac.za iv Free download from www.hsrcpress.ac.za v TABLE OF CONTENTS Foreword vii Authors ix C ontributors x Acknowledgements xi List of Tables and Figures xiii Acronyms and abbreviations xv Executive Summary xvi Chapter 1: Introduction 1 1.0 Background 1 1.1 Definition and prevalence of orphanhood and vulnerability 1 1.2 Rationale and aims of the study 4 1.3 Conceptual framework 5 Chapter 2: Methodology 7 2.1 Operational definitions 7 2.2 Description of the study sites 7 2.3 Geographical frame for the OVC Census 9 2.4 Instrument 9 2.4.1 Questionnaire design and its translation 9 2.4.2 Pre-testing of Census questionnaire 9 2.5 Ethical issues 10 2.6 Data collection 10 2.6.1 Pre-enumeration activities 10 2.7 Deployment of enumerators and supervisors 12 2.8 Quality control 12 2.9 Assessment of vulnerability 13 2.10 Data management and analysis 13 Chapter 3: Results 15 3.1 Bulilimamangwe District 15 3.1.1 Demographic data 15 3.1.2 Magnitude of orphanhood 18 3.1.3 Disability 19 3.1.4 Household level data 20 3.1.5 Main household vulnerability indicators 23 3.1.6 Other income indicators 26 3.2 Chimanimani District 27 3.2.1 Demographic data 27 3.2.2 Household level data 31 3.2.3 Main household vulnerability indicators 35 3.2.4 Other income indicators 37 Chapter 4: Discussion 39 Chapter 5: Conclusion and recommendations 43 5.1 Challenges faced during the study 44 5.2 Dissemination of results 44 Free download from www.hsrcpress.ac.za vi Appendices 47 Appendix 1 Ward Maps by District 47 Appendix 2 Reactions to the Pilot Research Procedures 52 Appendix 3 Fieldworker’s Introductory Letter 53 Appendix 4A Census Shona and English Questionnaire 54 Appendix 4B Code Sheet – Shona 56 Appendix 5A Census Ndebele and English Questionnaire 58 Appendix 5B Code Sheet – Ndebele 60 Appendix 6 Quality Control of Questionnaire Checklist 62 Appendix 7 List of Supervisors 63 Appendix 8 Ward Analysis of Census Results by District 64 Appendix 9 OVC 2003 Census Operational Structure 125 Appendix 10 Vulnerability Score Assessment 126 References 127 Free download from www.hsrcpress.ac.za vii FOREWORD In this era of the HIV and AIDS epidemic in sub-Saharan Africa and economic challenges in Zimbabwe, there is possibly no other subject that has received as much media attention of late, than that of the plight of orphans and vulnerable children, hence it is difficult to conceive of a more pertinent and perfectly timed publication than this one. Of the 3 million AIDS-related deaths globally, 2.2 million are from the sub-Saharan region. One major impact is that the disease has orphaned vast numbers of children, because those dying from AIDS are mainly in the prime of their lives and are parents. These children endure overwhelming losses; living in societies already weakened by under development, poverty, the AIDS pandemic itself and whose traditional support structures, like the extended family system, have been eroded by, among other factors, urbanisation. Faced with this unprecedented crisis, the Zimbabwe Government in 1999 introduced the compulsory AIDS levy from taxable incomes to raise money which is channelled to alleviate the suffering of people living with AIDS and their dependents, who are mostly orphans. It further complemented this effort by developing a National Orphan Care Policy to underpin the mobilisation of resources and ensure that orphans get, at least, minimal basic services. The Orphan Care Policy combines institutional, fostering, and community-based care. A plethora of interventions has been initiated by the government, Non-Governmental Organisations (NGOs), Faith-Based Organisations (FBOs) and Community-Based Organisations (CBOs), aimed at assisting Orphans and Vulnerable Children (OVC) and their caregivers. However, the work of intervention agencies is often undermined or made difficult by their use of data which is scant, outdated and vague, covering small geographical areas like wards, and is generally less objective in terms of how it identifies needy children and areas. Furthermore, the process of how they identify the needs of OVC in different households and localities is not well defined. Consequently, this at times leads to the implementation of badly focused interventions or selection of areas with fewer households which are vulnerable. The 2003 OVC Population Census in Bulilimamangwe and Chimanimani districts was the first of its kind to be undertaken in Zimbabwe. In the past, national censuses captured data on orphanhood status without obtaining data on vulnerable children. This census was done a year after the 2002 National Census. Thus the framework of operation and mapping of the districts was done within the framework of the 2002 National Census. However, while the 2002 National Census was taken on a de facto basis, the OVC Census used the de jure method. The additional information in this census was the household and individual vulnerability indicators, which were identified to assist in future interventions tailored for these districts. Vulnerability was assessed using the Vulnerability Indicator Score, which touched on broad aspects of children’s lives such as access to food, health care and protection. On behalf of the Ministry of Health and Child Welfare and the Government of Zimbabwe, I would like to express my gratitude to the funders of the Project, The W.K. Kellogg Foundation for championing and supporting the plight of OVC, and the Human Sciences Research Council (HSRC), in particular its new President and Chief Executive Officer, Consultant and Project Champion of the OVC Project, Dr Olive Shisana, who worked tirelessly to make the projects happen in the three selected countries. In addition, I acknowledge all persons who participated in the census exercise, especially the people of Bulilimamangwe (Bulilima, Mangwe and Plumtree districts) and Chimanimani, for their co-operation and support. Special mention is accorded to the research team from the Free download from www.hsrcpress.ac.za viii Biomedical Research and Training Institute (BRTI) and the National Institute of Health Research (formerly Blair Research) who successfully carried out this mammoth exercise under the leadership of the Project Director, Mrs Shungu Munyati, Project Manager Mr Brian Chandiwana and the Chief Consultant, Professor Simbarashe Rusakaniko. I am hopeful that this database can be used by my Ministry and others to mobilise additional resources that will be channelled towards improving the lives of orphaned and vulnerable children, their caregivers, and communities at large. I also fervently hope that this database, which shows the magnitude of the Orphans and Vulnerable Children’s problem across the districts at household and ward level, will lead to the formulation and implementation of both relevant national policies and evidence-based interventions by CBOs, FBOs, NGOs and government structures aimed at tackling the pertinent challenges confronted by the OVC. Dr David Parirenyatwa (MP) Minister of Health and Child Welfare, Zimbabwe May 2005 Free download from www.hsrcpress.ac.za ix AUTHORS The Editor: Shungu Munyati – MSc, BSc (Hons) Applied Biology, PhD Candidate; OVC Research Project Director and Acting Director, National Institute of Health Research (NIHR), Ministry of Health & Child Welfare, Harare (Zimbabwe). Simbarashe Rusakaniko – PhD; OVC Research Project Chief Consultant Biostatistician, University of Zimbabwe, College of Health Sciences, Harare (Zimbabwe). Pakuromunhu Freddie Mupambireyi – MSc Demography, BSc (Hons) Econs Statistician, University of Zimbabwe, Deputy Dean, Faculty of Commerce, Harare (Zimbabwe). Stanford Taonatose Mahati – MPhil, BSc (Hons) Sociology & Anthropology, Social Scientist, National Institute of Health Research (NIHR), Ministry of Health & Child Welfare, Harare (Zimbabwe). Peter P Chibatamoto – MBA, MSc Infectious Diseases, Biological Sciences; HIV/AIDS (Mainstreaming) Technical Advisor UNDP, Windhoek (Namibia). Brian Chandiwana – BSc Econs & MBA, OVC Research Project Manager; Health Economist, Biomedical Research & Training Institute, Harare (Zimbabwe). Free download from www.hsrcpress.ac.za x CONTRIBUTORS George Chitiyo – MSc & BSc Econs; PhD (Cand), USA. Wilson Mashange – Dip Med Lab Tech; National Institute of Health Research (NIHR), Ministry of Health & Child Welfare, Harare (Zimbabwe). Junior Mutsvangwa – BSc Medical Laboratory Technology and MPhil (Cand), Biomedical Research & Training Institute, Harare (Zimbabwe). Natsayi Chimbindi – BSc HEP, (Health Education), Biomedical Research & Training Institute, Harare (Zimbabwe). Free download from www.hsrcpress.ac.za [...]... and monitor the HIV/AIDS OVC Operational Framework and provide research to support innovative and sustainable models that target orphans and vulnerable children, as well as families and households coping with an increased burden of care for affected children The OVC Census was one of such research studies 1.1 Definition and prevalence of orphanhood and vulnerability The definition of an ‘orphan’ varies... on orphans and vulnerable children (OVC), as well as families and households coping with an increased burden of care for affected children in Botswana, South Africa and Zimbabwe The goals of the project are to: • Improve the social conditions, health, development and quality of life of vulnerable children and orphans • Support families and households coping with an increased burden of care for affected... training and supervision In each district the research team was accordingly split into five teams and each team was assigned a cluster to train and supervise The supervisors assisted in the training of their enumerators A summary table for the total number of enumerators and supervisors trained in the enumeration areas is given in Table 1 below Table 1: Distribution of wards and enumeration areas (EAs)... work cannot be overemphasised Population censuses are a principal means of collecting basic population statistics They form part of an integrated programme of data collection and compilation aimed at providing a comprehensive source of statistical information for economic and social development planning, for administrative purposes, for assessing conditions in human settlements, for research and for... total population of 12 million It is estimated that by the year 2010 one out of every three or four children in Botswana, Malawi, Tanzania, Uganda, Zambia and Zimbabwe will be an orphan A generation of orphans are being cared for by grandparents, family members or through self-care in childheaded households (UNAIDS, 2002) According to UNICEF (2003), there were 240 000 Zimbabwean children (0–14 years)... means that their impact is fragmented and existing resources cannot be utilised in a manner that fully benefits children The harsh socio-economic situation in Zimbabwe has resulted in alarming increases in children with the basic survival needs for food and health services In Zimbabwe generally, national policies and laws establishing the legal infrastructure for the co-ordination of OVC programmes and. .. smallest demarcation of each district, known as the enumeration areas (EAs) Consultants who work for Zimbabwe’s Central Statistics Office (CSO), using the 2002 National Census (Zimbabwe Census 2002 Preliminary Report) border definitions, mapped the boundaries of each ward and its enumeration areas On average, each enumeration area was assigned to one enumerator with an average of six EAs constituting... protecting children against abuse is often fragmented, generally requiring access to legal advocacy to ensure that the law is carried out in favour of the child Generally, the GOZ, NGOs and the international community (donors) are now recognising that approaching community initiatives collectively results in significant gains for OVC Escalating numbers of OVC mean that line ministries, local organisations... facilities and sources of energy has been well documented The results have also identified gaps at population level that need to be addressed, like the need for toilet facilities and clean water Around a quarter of the children were orphans across the two sites and there were more paternal orphans than maternal orphans Shortage of food and lack of adequate clothing seemed to be the major problems facing... be prepared, together with recommendations on potential interventions in rural development programming On completion and submission of the report to WKKF, HSRC was then asked to produce a draft strategy for the care of orphans and vulnerable children in Botswana, South Africa and Zimbabwe, a task that was undertaken jointly by SAHA and the Child, Youth and Family Development (CYFD) programme of the . facilities and clean water. Around a quarter of the children were orphans across the two sites and there were more paternal orphans than maternal orphans. . research to support innovative and sustainable models that target orphans and vulnerable children, as well as families and households coping with an increased