Health care provision poses a major challenge

This year’s celebration of the Day of the African Child has as its theme “The African Child and the family”. The aim according to the Girl Child Network, GCN, is to “underscore the important role of the family in the life of the child and sensitize the public on the values of the African Child in the family and the family unit as a whole”. But challenges are many.

Later this year, Kenya is set to report for the first time her progress in adopting and domesticating the African Charter of the Rights and Welfare of the Children to the African union and also give her second report to the Geneva based Convention on the Rights of the Child, CRC.

But while the country can boast of her strides in the provision of the universal free primary education, in her commitment to safety and security of the children, on culture and basic needs among other thematic areas, the same cannot be said on the health component.

This year, the day of the African child, observed annually on 16 June, comes at a time when the country is hotly discussing the pros and cons on her planned new health scheme, supposed to come into effect from the 1st of July. This scheme is aimed to reach a wide number of the members of the public than any other health reforms before and promises to be evolutionary.

But concern among pro-child rights organsiations is that little of the children own proposals are being factored in this planned scheme. According to the Kenya Alliance for the Advancement of the Children Rights, [KAACR], health issue tops the list among the priority of children.

A survey that KAACR carried out among 7 out of 8 provinces in Kenya show that the high cost of health care, long distance to health facilities, rare health facilities and nutritional issues ranked high among concerns of the Kenyan children.

The situation becomes precarious with HIV/AIDS scourge in the picture. According to UNICEF and UNAIDS, the number of orphans is rising dramatically as the pandemic continues to claim lives of young adults not only in the country, but also in the continent.

Currently, 1.2million Kenyan children are orphaned. Globally, 16 million children under age 15 have already lost either one or both parents to AIDS and HIV/AIDS is causing the overall orphan rate to rise.

Because of AIDS, the number of orphans in Kenya and the region is increasing dramatically, instead of declining. Orphans number more than 34 million in the region, 11 million of whom are AIDS orphans.

By the end of 2001 in sub-Saharan Africa, 12 per cent of children currently under 15 years of age had lost a mother, father or both parents to AIDS.

This is almost double the proportion of orphans in Asia at 6 per cent and more than double that found in Latin America at 5 per cent.

But lack of care and support for majority of those orphaned by HIVAIDS is one of the areas Kenya and most countries in the region miss out.

According to Jennifer Otieno, Executive Director, Mothers Rural Care for AIDS, Kenya, “the situation mostly today is that once AIDS has killed both parents they are left on their own”.

She adds that interventions are few and isolated and tend to send the orphans back to their parent’s rural homes, where they have little attachment.

A recent World Bank report shows that in 20 out of 28 countries in Africa and Latin America, more than one-fifth of orphaned children were living with their grandparents.

When parents die, often leaving several orphans, the economic, social and psychological strains on the older persons cannot be underestimated, the report argues.

In Zambia, Uganda and Tanzania, grandparents made up the single largest category of carers for orphans.

According to a report recently released by the HelpAge International and the International HIV/AIDS Alliance, “the older people have taken on new roles by providing care and playing child rearing roles within their extended families”.

The report says that the elderly are, amidst great difficulties, also providing financial support to orphaned children and continuing their more traditional roles as advisors to their adult children and grandchildren.

They largely absorb the enormous additional burdens placed on families and societies by the AIDS pandemic.

According to Prof. Rodreck Mupedziswa, Chief Programme Officer, Forced Migration Studies, University of Witwatersrand, South Africa, “access to and use of health services are very poor in most of the sub-Saharan Africa, due to the extreme poverty of many and a lack of clear commitments from the regional governments”.

“Clearly the problems faced are more than they can bear. Access, restricted by distance and cost, is the main factor hindering the use of health care services”, adds Mupedziswa.

The HelpAge International/AIDS Alliance report says that the attitude of health staff in most parts of the sub-Saharan Africa is found to hinder people’s willingness to utilise health care services.

Complaints made focused mainly on the negative attitude of health workers towards the primary caregiver and the People living With AIDS.

The report says that apart from the high cost of treatment, which has further impoverished most households, poor infrastructure and hospital equipment caused major problems.

Although the African Charter on the Rights and Welfare of the Child was adopted on 11July, 1990 and came into force on 29 November 1999 the process of ratification by member states of the OAU/AU, has been very slow.

The Day provides an opportunity to celebrate the historic United Nations Special Session on Children and to promote implementation of the new goals for children set at the Special Session. In countries throughout Africa, UNICEF is supporting a variety of activities.

According to Lady Justice Joyce Aluoch, head of the High Court’s family division in Kenya, “the African Charter on the Rights and Welfare of the Child is progressive because right from inception, it provides for the right to enjoy the best attainable of state of physical, mental and spiritual health. It also calls for state parties to undertake to reduce infant and child mortality rates in Article 14”.

But the challenge is, according to Justice Aluoch, is that as of last year of the 53 African Union member states, only 27 had ratified the Charter and few of these states have made any real strides to undertaking these measures.

The day of the African child is earmarked to remember an incident in Soweto, South Africa in which thousands of black school children took to the streets in 1976, in a march more than half a mile long, to protest the inferior quality of their education and to demand their right to be taught in their own language.

Hundreds of young boys and girls were shot dead and in the two weeks of protest that followed more than a hundred people were killed and more than a thousand were injured.