- Introduction and Overview of Possible Interventions
In accordance with the World Bank’s health sector strategy, by health we refer to projects related to nutrition and psychosocial health as well as more traditional heath issues like preventive campaigns (in particular related to social behavior, hygiene, water and sanitation), immunization, accidents, and treatment of childhood diseases and injuries. Most OVC are more exposed to health risks than other poor children, and commonly face some typical obstacles to participation even in health programs targeting the poor.
Before deciding which interventions your health project should include, you will need to decide whether you intend to serve all OVC or one or more specific groups. Your decision will depend on
- how many children fall into each of these categories (see Background research section);
- which groups the government considers as high priority; and
- how much funding is available for OVC activities.
It is recommended to target vulnerable children more in general. Using rigid targeting criteria related to certain sub-categories of OVC in order to determine a given child’s eligibility for project participation will in practice easily turn out to be both economically inefficient and will often also be perceived as “unfair”.
Once you have decided which OVC groups your program will target, you will need to decide which interventions to finance. In this section we provide some information on a number of the interventions listed below to facilitate your decision.
Overview of Possible Interventions
We recommend that you focus your attention on incorporating one or several of the project design features outlined below. This is not intended to be an exhaustive list. We have included interventions that either play a critical role in limiting the number of OVC (e.g., role of immunization in preventing disability) or those that are designed to address the special needs of OVC. If you have the time and money, we encourage you to organize a stakeholders meeting as described in the section on working with partners. While more time-consuming, the participatory diagnostic process will both improve the quality of information you gather and build local ownership and commitment.
Most Likely Project Design Features – Health Sector |
All OVC |
- Conditional transfers linked to participation in well-child activities (e.g., immunizations, growth monitoring)
- Fee waivers and exemptions
- Offer school-based comprehensive health services, such as in the FRESH program (however, this approach will not reach out-of-school OVC)
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| Project Design Features by OVC Category |
Street Children |
- Offer free or subsidized health services in collaboration with specialized NGOs.
- Make health information available to children who live in streets and public places
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Orphans |
- Offer free or subsidized health services (possibly including caretakers)
- Develop simple protocol to diagnose psycho-social problems as part of routine health assessment
- Develop follow-up services for children suffering from psycho-social problems
- Develop special outreach services for children heads of households to enhance their ability to keep their siblings healthy
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HIV/AIDS affected children |
- Develop psycho-social support program for children living in HIV-affected households
- Develop training program in appropriate care for AIDS patients, including prevention of transmission
- Develop home visitor programs to assist children in affected households to care for AIDS patients
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Children associated with armed groups |
- Develop psycho-social support program for children who have been associated with armed groups
- Assess the special health needs of children formerly associated with armed groups
- Provide voluntary STD testing and prevention information
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Children in the worst forms of child labor |
- Develop psycho-social support program for children who have been in the worst forms of child labor (in particular prostitution)
- Assess the special health needs of children in or formerly in any of the worst or most hazardous forms of child labor
- Ensure that health information campaigns reach children in secluded work places like mines and quarries
- Provide voluntary STD testing and prevention information
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Children Victims of Abuse |
- Train primary health care professionals to recognize child abuse and advise parents of long-term emotional and physical consequences, especially regarding sexual abuse
- Develop programs to discourage traditional harmful practices (e.g., female genital cutting, forced early marriages)
- Organize Information and Education Campaign (IEC) to prevent abusive behaviors toward children, such as excessive corporal punishment and sexual violence (this may be done as part of a broader campaign against domestic violence or against all sexual violence)
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Children living with a disability |
- Ensure that all health care facilities constructed are accessible to disabled children
- Educate the parents and caretakers of children living with a disability to provide routine therapy to prevent further deterioration
- Offer specialized therapy to disabled children
- Establish a community-based rehabilitation program (although it is not limited to children, children are the main beneficiaries)
- Develop community-based home visitor program to assist home-bound children and their families
- When providing health information, ensure that it is also available to children with sensory challenges like blindness and deafness
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