Start Early, Start Now – Integrated interventions for young children born into HIV-affected families

April 17, 2014

Now more than ever, there is need to reach the youngest children affected by HIV and AIDS, and not to lose them in the first six years of their lives. We can achieve this by delivering an integrated package of services. By breaking down the silos that have persisted among the health, HIV, early child development, protection and social welfare sectors. Start early, start now: find out why and how!

The first six years in life are pivotal

We know that HIV poses a biological risk for child development. We know that children infected or affected by HIV experience higher rates of developmental delays. The effects come from antiretroviral therapies, physical and mental health challenges and stresses (also for the parents), the added economic burden of HIV and stigma, which has negative health and social impactson both parents, caregivers and children.

The first six years are pivotal for brain and physical development, which sets the stage for future wellbeing. However, the youngest children are too often missed in HIV testing and treatment efforts as well as in early learning programs. We have to make sure we will prevent harm rather than wait for children to arrive on our doorsteps years later, when they've undergone hardship and are sick, stigmatized or traumatized. 

An early, integrated approach - how we do it

An early, integrated approach will protect children but it will also help them thrive. In the long run, it will be more efficient and far cheaper. Decades of research prove the short and long-term benefits—health, social and economic—of focusing on the early years.

So, how do we do it, building program connections? Quite simple:
1. Finding children and families and not losing them!
2. Integrating clinical and developmental interventions for young children born into families affected by HIV.
3. Extending the period of support and thus preventing further harm done.
This way we can provide children with a strong foundation for the rest of their lives.

Some examples:

  • In prevention parent to child transmission of HIV programs, make sure to also identify other siblings in the family and enrol them in HIV testing and treatment programs.
  • In Early Childhood Development (ECD) programmes invite clinics to do HIV tests among the children and their parents, and to provide ARTs. 
  • In mother to child transmission prevention and treatment programmes invite ECD workers to provide ECD activities to the children and support the parents to stimulate the development of their children. 
  • Organize Child Health Days in the community, which cover a number of health aspects and bring the services closer to the people: TB screening, HIV testing, growth monitoring, cooking demonstrations, play demonstrations, etc. 
  • In immunisation campaigns and in the Maternal Newborn and Child Health clinics integrate HIV testing and treatment. 

5840 days of childhood care

Now more than ever, resources are limited, so we need cost-effective interventions. Early, integrated interventions are proven to be effective and can prevent high costs in the future. We need to focus on inclusion of the first six years to provide the entire continuum of care for the entire 5840 days of a human's childhood. So we have to START EARLY and START NOW!

This article is a compilation of findings of the three 'Road to Melbourne'-Meetings of the Coalition for Children Affected by AIDS. The meeting reports and presentations can be found on the Coalition's website. 

By: Doortje ‘t Hart - Senior Advisor Children affected by AIDS - STOP AIDS NOW! and member of the Coalition for Children affected by AIDS

This article was published in the Children and AIDS e-news April 2014