The first phase of the Children Affected by HIV and AIDS Strategy was approved by the Conrad N. Hilton Foundation’s Board of Director’s for 2012-16 to address early childhood development (ECD) for young children from 0-5 years affected by HIV and AIDS – with a focus on improving cognitive, social and physical development outcomes. The Board approved a total of $51 million for investments focused on five countries in East and Southern Africa: Kenya, Malawi, Mozambique, Tanzania and Zambia. These past five years have been a learning opportunity for the Foundation and partners alike. The Foundation has established partnerships with a strong group of leading implementing organizations in the fields of HIV and AIDS, maternal and child health and ECD as well as with many community-based organizations (CBOs) and government departments. Of the many achievements accomplished in the first phase, a particularly noteworthy one is the inclusion and integration of ECD as part of large-scale programming to reach large numbers of young children and caregivers (415,000 and 320,000, respectively) with information and services. As one of the few funders working to address ECD targeting vulnerable children and families affected by HIV and AIDS, we have invested in field-building support including training, convening and knowledge sharing via publications, including support for a special edition of The Lancet.
Our emphasis on monitoring, evaluation and learning, and our partnership with the Human Sciences Research Council (HSRC) in this effort, has created a vibrant community of practice that has enabled sharing and collaboration. Lessons learned include the need to shift from emphasizing large numbers reached to implementing higher quality programming that can be scaled as part of existing systems and that includes research to build the evidence base concerning what works in these East and Southern African country settings. A major lesson learned was that, while the science indicates that a child’s first 1,000 days (from conception through age two) is the most critical time period for development, most people equate ECD with pre-school programming and hence our partners primarily reached pre-school age children. With this in mind, we began to invest in efforts to reach pregnant women and young children within the health sector (including as part of HIV treatment programs) that have showed much promise.
The landscape for ECD for vulnerable children affected by HIV and AIDS has changed over the past five years. There is currently unprecedented support for moving from a child survival paradigm to fostering early childhood development to enable children to survive and thrive, which will boost future economic prosperity in the long term. The Sustainable Development Goals (SDGs) include early childhood development (target 4.2) and the World Bank has called for prioritization of ECD to enable countries to compete in the new global economy. The Foundation’s second phase strategy thus comes at an opportune time when the Foundation can join forces with a growing coalition of actors to contribute to reaching the SDGs by 2030 and specifically to demonstrate effective, scalable approaches to improve developmental outcomes for young children (0-5 years) affected by HIV and AIDS in Kenya, Malawi, Mozambique, Tanzania and Zambia. Our strategy seeks to leverage the increased commitment and political will that ECD is benefiting from, while addressing key challenges including a lack of evidence regarding effective ECD approaches in these African country settings. Therefore, over the next five years, we will focus on identifying and testing approaches that have the potential to improve cognitive, social and physical development.
In doing so, the Foundation will make investments in three inter-related focus areas: 1) advancing program approaches to improve caregiving and early learning; 2) strengthening civil society and government systems and networks; and 3) building and disseminating evidence to improve practice and policy. These three approaches will be applied in an integrated way within our five focus countries in East and Southern Africa.