(Western
Childrens
HIV/AIDS Network
A
network of organisations working with
Children
infected and/ or affected by HIV/AIDS
SUBMISSION on the
Children’s Amendment
Bill [B 19B-2006] from
WC-NACOSA- CHAIN
(Children’s HIV/AIDS
Network)
WC-NACOSA-CHAIN network: CHAIN is the children’s
sector of WC-NACOSA, a network of over a 170 organisations comprising of Non Governmental
Organisations, Community Based
Organisations, Faith Based Organisations, government officials and a diverse
array of children’s service providers in the HIV and AIDS sector as well as
concerned individuals working in the Western Cape on children’s HIV and AIDS issues.
Contact
person:
Menaka
Jayakody, Coordinator Children’s HIV/AIDS Network (CHAIN)
1. Introduction
WC-NACOSA
CHAIN welcomes the opportunity to be able to engage with the Portfolio
Committee on Social Development on the Children’s Amendment Bill. Some of our concerns about the Bill were
raised in the submission made by WC-NACOSA CHAIN during the public hearings
held in the
The AIDS pandemic represents a phenomenon, not unlike that
of poverty, which is both causal and symptomatic of so many other
vulnerabilities of childhood. Almost every section of the Bill is therefore
relevant to children in the context of HIV/AIDS. However, this submission
focuses on areas of particular concern to individuals and organisations within
the HIV/AIDS sector, and is intended to complement the many other sector
submissions that address issues of direct relevance to children living in AIDS-affected
communities.
Nationally and internationally, our response to the
socio-economic impact of HIV/AIDS on children tends to focus on children who
have been orphaned. However orphanhood in itself is a process that begins long
before the death of a child’s caregiver, with differently compounded
vulnerabilities at different points along this continuum. Research repeatedly demonstrates that the
period of a caregiver’s terminal illness is one during which children are prone
to exacerbated vulnerability – in which caregivers typically face increased
struggles to support their children as they become less able to work to earn
money and as cash is diverted to health care and treatment. Our emphasis is
thus also to highlight the vulnerability that HIV/AIDS exacerbates on children
already made vulnerable due to poverty, violence, neglect and abuse and
disability.
The 5.3 million South Africans currently living with
HIV/AIDS translate into millions of children whose well-being is potentially
compromised by adult illness and whose protection, care and support need to be
ensured through the provisions of the Children’s Bill.
2. Our Broad
Concerns:
2.1 A balance between
prevention, early intervention services and formal child protection services
Prevention and early intervention services need to be
strengthened and resourced so that the child protection system is used for
protection of the child who is most vulnerable and requires statutory
protection services. There are different
levels and complexities of vulnerability.
Some children are in need of the formal child protection system, while
others can be cared for and supported through strengthening prevention and early
intervention services at community, neighbourhood and family levels.
2.2 Comprehensive
social security package
In the absence of comprehensive social security for children
and families made vulnerable by HIV/AIDS, many families, carers and community
based organisations use the foster care grant as a poverty alleviation measure. This overburdens the foster care system which
was intended for children needing protection and therapeutic support. Social workers are not able to deal with many
of the urgent issues facing families, carers and communities caring for children.
There is no comprehensive social security system that is
based on the current reality of the country in terms of poverty levels and the
effect of the HIV/AIDS epidemic on extended families, households and
communities. We strongly recommend that there
needs to be mechanisms in place to enable families, carers and children to
access a comprehensive social security package that includes basic entitlements
like nutrition, psychosocial support and care and education. This system needs to build in a sense of urgency
in neighbourhoods and communities in caring for children that is not only
monetary but includes children’s holistic development. It needs to take cognizance of the context of
poverty within which there are different levels of vulnerability.
2.3 Interdepartmental
cooperation and coordination
It is the experience of the NGO/CBO sector in dealing with service
delivery for children that there is a lack of interdepartmental cooperation and
coordination. There are fragmented
processes at national, provincial and local levels between different
departments and even within departments that lead to duplication and a wastage
of resources or lack of delivery. Proper interdepartmental coordination and
collaboration will be more effective in combating the AIDS epidemic in our
communities.
There are good practice models of how in some communities
there have been good examples of interdepartmental communication and joint
planning taking into consideration public participation and we commend this. It is especially important for a child made
vulnerable by HIV/AIDS to have many departments affecting them in some way
during the course of their lives - from birth (with birth certificates, PMTCT),
to ARV support and clinic support, to school support (nutrition). They also require social services to assist
with grants and psychosocial support and care where necessary. There is a great need for interdepartmental
cooperation and coordination to be translated into the lives of children,
families and communities. More importantly, government must inject more
resources into prevention and early intervention services.
3. Discussion of
specific clauses and proposed amendments:
Chapter 1:
Definitions
|
Clause |
Proposed Amendments |
Discussion |
|
1 |
We agree
with the NACCW proposed amendments: Insert a
definition of “child and youth care
worker” Insert
references to roles of child and youth care workers where relevant in
chapters 5, 6, 7, 8, 11 and 12. |
Child and
youth care workers provide a range of child protection and care services,
recognised by SACSAP and recommend a definition of child and youth care
worker and child and youth care work, as suggested in the NACCW submission:
“Child and youth care is direct protective, developmental and ameliorative
practice within the lifespace of a young person in the community, the family
or a group care/education setting. It’s aim through the use of positive
relationships and planned programming is to address emotional and behavioural
issues, thus promoting improved functioning and development.” Children infected and affected by HIV and AIDS are
supported by child and youth care workers, in the rural setting as well as in
urban settings. They provide a system of working with children within the
child’s and young person’s lifespace at community, family and group level. |
Chapter 5: Partial Care
|
Clause |
Proposed Amendments |
Discussion |
|
Partial
care Clause 76 |
All NPO
disability centres offering partial care for children need to be recognised,
funded and regulated by the Department of Social Development. These include
developmental stimulation programmes and programmes for physical
rehabilitation and therapy. NPO early
childhood development services must be funded and regulated by departments of
Social Development, Health and Education. |
Services
provided to the most vulnerable children - including children with disability
or chronic illness, in this case HIV, must be adequately provided for and
funded by government. Centres offering partial care should be regulated and
empowered to provide services in accordance with set norms and standards. Children infected by HIV often present with specific
developmental delays as well as in some cases other disabilities such as
cerebral palsy, learning disabilities.
Thus these children are included in the services provided to children
with disability. We agree
with the SA Congress for Early childhood Development and Early Learning
Resource Unit that a comprehensive inclusive and funded early childhood development
service is required. Partial care
addresses the regulation and funding of the facilities and the principles of
access and redress are important given the vast disparities which continue to
affect the majority of children in We recommend that within a comprehensive service, the
needs of HIV positive children and children affected by HIV and AIDS be
addressed through programmes addressing psychosocial support and care for children
and families, health care, treatment adherence support programmes and nutritional
support. |
|
Cl 77 Strategy
concerning partial care |
We commend
the inclusion of reference of clause 11 in the strategy for partial care. |
Children
with disability as well as children living with HIV do not always have equal
access to partial care facilities because of their HIV status or disability.
In order to promote equality and non discrimination of these children,
provincial departments need to plan explicitly for equal access and tackle
the stigma and discrimination that occurs.
There needs to be a strategy in place to ensure sufficient provision
of partial care facilities for children infected or affected by HIV and AIDS,
included under chronic illness and disability. |
|
Cl 79 Norms and
standards for partial care |
We support
the recommendation from the DICAG submission and the SACECD and ELRU that
there need to be norms and standards for developmental and therapeutic
programmes that are inclusive of children with disability or chronic
illnesses; physical access and a safe environment for them; training for
partial care personnel, which includes diversity training, first aid and
universal precautions, psychosocial care and support, developmental
stimulation, nutritional support for children and support for treatment. |
Norms and
standards must be cross referenced to chapter 6 for every ECD facility to
include an educational stimulation programme appropriate to the developmental
needs of children. We must
ensure that children would also receive appropriate psychosocial support and
care for families as well as themselves, nutritional support, treatment and
healthcare support as well as developmental stimulation in the partial care
facility. |
|
Cl 81 (c) Application
for registration |
Insert: ii) Any
documents may be prescribed by regulation must be user friendly and
accessible. |
Many
people running partial care facilities need to know how to access the
relevant forms and would find it difficult to complete complex application
forms. |
|
Cl 82 (2)
(b)(c)(d) and (3) |
|
Clear
guidelines are required regarding a person who is not fit and proper to work
in a partial care facility. This should bear in mind the protection of the
child from abuse and neglect and from persons who have had a history or
criminal record, nationally or internationally of abuse, neglect, violence,
child trafficking, pornography etc. |
|
Cl 85
Notice of enforcement |
Insert: If a partial care facility is closed then
alternative arrangements must be made with immediate effect. |
Closure of
partial care facilities leads to difficulties for the parents/caregivers as
alternatives are hard to find in some places and children return home to wait
indefinitely. Especially for children who are heading households to look for
alternative arrangements for their siblings is an added responsibility to
their already existing burden of care. |
|
Cl 88 Assignment
of functions to municipality |
88 (1) It
is recommended that clause 87 be excluded from the delegated functions to
municipalities. Provisions need to be
made for the improvement of inter-sectoral collaboration at this level as
well as municipalities being capacitated by provincial government in order to
fulfil these functions. |
Provinces
need to keep a record of all facilities and plan the service delivery
accordingly. An integrated and
comprehensive approach needs to be adopted with structures and mechanisms for
collaboration between sectors. Many municipalities need to be capacitated to
have a child-focus in carrying out the functions stipulated and may need
training and support to do so. HIV and AIDS is a focus area in the IDP
strategies of the municipalities in the |
Chapter 6: Early Childhood Development
|
Clause |
Proposed Amendments |
Discussion |
|
Definition
of ECD Clause 91
(1) |
We agree
with the DICAG submission insertion: Early Childhood development for the
purposes of this act, means the processes of emotional, mental, spiritual,
physical and social development of children from birth to school-going age
taking into consideration the child’s developmental stage. |
The current
definition of ECD is stated as being from birth to school going age, defined
by the DOE as 4 years. Due to the many barriers to learning and development
that is experienced by disabled children, and children infected and affected
by HIV/AIDS, including lack of appropriate learning materials and access to
facilities. They might not achieve developmental milestones at the same time
as other children. They then remain in formal ECD or informal centres even
after reaching school-going age. Yet these children still need opportunities for
support and development as well as additional psychosocial support and care. |
|
Clause 91
(2) |
Insert:
Early childhood development services means services: (a) intended
to promote early childhood development
including the provision of facilities, staff training, equipment and
materials. (b) Provided
by a person other then by a Child’s
parent or pri (c) The
definition of ECD services needs to be
extended to include holistic programmes as follows: An ECD programme means
a programme structured within an ECD service to provide educational
stimulation, psychosocial support and care, nutritional support, treatment
adherence support appropriate to the child’s developmental age and
stage; programmes that provide support to families/care-givers. |
Á
distinction needs to be drawn between ECD services and ECD programmes. Early
Childhood Development programmes include a holistic range of programmes to
support child development including direct support for the role of
care-givers and families as a child’s first duty-bearer. Programmes
include those that provide support to families and care-givers of children
with disabilities and chronic illnesses and to children and families living
in poverty and difficult circumstances as well as to those in more well off
circumstances. ECD is the
first line of prevention and intervention for children and families and this
is particularly important for those infected or affected by HIV/AIDS. ECD
programmes need to consider including prevention education, treatment care
and support, nutritional support and additional support for children living
in child-headed households. |
|
Clause 92 |
Insert: The
minister after consultation with… must develop a comprehensive national
strategy that is published for public comment before finalisation and is aimed at securing a properly
resourced… |
In the
interest of participatory democracy, any strategy should be made available
for public comment and a participatory consultation process with civil
society and various non-governmental role-players. |
|
Clause 93 |
1. Should
say must instead of may |
|
Chapter 7: Protection of Children
|
Clause |
Proposed amendment |
Discussion |
|
Clause 106 Norms and standards concerning child protection |
(2) Norms and standards must relate to: (q) monitoring; and
(r) psychosocial support to both child and carers |
There need to be mechanisms to monitor children who are
being protected because of the abuse suffered and provision of psychological
support for better development and integration. |
We commend the Department of Social Development for the
inclusion of a provision in the Bill that recognizes the existence of
child-headed households and offers support and services for children in these
households.
Chapter 8:
Prevention and early intervention services
Prevention and early intervention services need to be
resourced and emphasized at family, household and community level to promote
healthy, caring and strengthened communities.
|
Section 143 Prevention and early intervention programmes |
143(2)(a) Prevention and early intervention must serve
also the purpose of promoting social cohesion. (b) Prevention services should also be provided to child
headed households |
Lack of social cohesion has the potential to negatively
effect the child development and further exposing the child to risk of harm
or disability. Child headed households often lack capacity and strength
to prevent and address abuse that occurs or are bound to occur in households.
|
|
Section 144 Purposes of prevention and early intervention
programmes |
Prevention and early Intervention must focus on: (l) (j) Development and promotion of parenting skills
training (2) (c) assisting families to access appropriate
information on prevention and early intervention services |
Many parents are unable to provide proper parenting to
children, leaving them vulnerable. Parenting
skills and appropriate early intervention services should also be made
available to caregivers such as grandmothers, foster parents in an accessible
manner taking into consideration diversity of learning styles, culture, age
etc. Many children affected by HIV/AIDS live in granny-headed households or
with extended families. |
|
Section 145 Provision of prevention and early intervention
service |
The provision prevention and early intervention should be
done based on professional recommendation. |
There needs to be a professional assessment to determine
the extent of the family problem before it can be given priority. Families
with disabled children lacking proper shelter, food and other basic
necessities of life should be given priority after assessment. |
|
Section 145 Strategy for securing prevention and early
intervention |
We recommend that the strategy aimed at securing provision of prevention and early intervention
should include child protection organisations
|
Child protection organisations contribute to reduction of
further risk that child can further be exposed and provision of alternative
place of care for children at risk of harm or disability. |
Chapter 12: Foster
care
We call for greater clarity around foster care for children
living with HIV/AIDS (both affected and infected). The current experience is
that there are different practices with regard to grants, where foster care grants are used as a poverty alleviation
measure especially in households doubly hit by HIV/AIDS and poverty and that
this also is dependant on different judges, municipalities, understandings etc.
There is also a need to see the foster care system and the formal child
protection system as performing its function of protecting those children in
need of direct social worker intervention and therapeutic support. However there is an urgent need to provide a
more comprehensive social security package for all children taking into
consideration the complexity and different levels of vulnerability.
Chapter 13: Child and Youth Care Centres
We welcome
the provision of child and youth care centres in the Children’s Amendment Bill
since with the previous Act organisations offering therapeutic care and support
for children infected and affected by HIV and AIDS did not have a category to
be registered under, and only temporary safety was only offered by government.
We support that these services can now be offered by institutions other than
government and there will be a place for registration (e.g. Cotlands in the
|
Clause 208
(1) |
We welcome
and support this section |
We support
the proposal in subsection (1) that all child and youth care centres have
management boards |
|
Clause 208
(6) |
The
management board must create a children’s forum dependant on the age, maturity
and ability of children to participate in decision-making as part of the
management board to ensure the participation of resident children in the
operation of the centre. |
Some
organisations working with children have children up to the age of 7 years or
children with cognitive disabilities, thus when creating a children’s forum
the age, maturity and emotional readiness in such decision-making should be
taken into account. |