The hiv/aids epidemic



During the course Education & Development in Diverse Societies we learned about the main educational theories and other (inter)disciplinary approaches to study educational issues in developing countries. We analysed educational reforms and innovations from an interdisciplinary and multilevel perspective, and examined their theoretical basis, the practical implications, the strengths and weaknesses, and how they respond to the learning needs of children with a diverse background.[1] In this paper I will apply the knowledge and understanding that I gained by writing about the impact of the HIV/AIDS epidemic on basic education for children at risk.[2]

The AIDS epidemic has become a global crisis - currently threatening the lives of millions of people and devastating entire societies. Education systems have an essential role to play in fighting this epidemic, because of their capacity to reach very large numbers of young people with life-saving information and skills. A completed primary education can reduce the risk of HIV infection for young people; and in fact, basic education has such a powerful preventative effect, that it has been described as the 'social vaccine' (Boler & Carroll 2003). As the epidemic gathers pace, however, it poses increasing risks to education itself, threatening to stop children from enrolling, teachers from teaching and schools from functioning. This threatens the Right to Education, and the objective of Education for All (EFA) and the Millennium Development Goal (MDG) to achieve primary universal education. Particularly, orphans and vulnerable children (OVCs), face a lot of challenges in the provision of quality education.[3]

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In this paper, I therefore focus on the impact of the HIV/AIDS epidemic on basic education for orphans and vulnerable children in Sub Saharan Africa in order to improve and increase their access to quality education, skills development and other social services. Since I am going to conduct research in Zambia on a related topic, I focus particularly on the impact of HIV/AIDS epidemic on basic education in Zambia. The research questions of this paper therefore state: What is the impact of the HIV/AIDS epidemic on basic education for orphaned and vulnerable children (OVCs) in Zambia? What can be done to increase their access, progression and educational outcomes?

Part one of this paper deals with the more general literature about HIV/AIDS in Sub Saharan Africa. This includes the impact of HIV/AIDS, leading to many different educational consequences. In part two I focus on Zambia as a case study, whereby I explain the HIV/AIDS epidemic in Zambia, the impact it has on OVCs and the educational system. Part three discusses the possibilities of redressing the harmful consequences within the educational system, whereby I focus on community schools. In conclusion, I answer the research question and I will give recommendations for further research.

The HIV/AIDS epidemic in Sub Saharan Africa

Two-thirds of all people infected with HIV/AIDS live in Sub Saharan Africa, although this region includes little more than 10% of the world's population (UNAIDS 2008; Foster & Williamson 2000: 275; Barnett & Whiteside 2006: 210-19). HIV/AIDS has caused immense human suffering in the continent. The most obvious effect of this crisis has been illness and death, but the impact of the epidemic has certainly not been confined to the health sector. Households, schools, workplaces and economies have also been badly affected. Since the beginning of the epidemic more than 15 million Africans have died from AIDS (UNAIDS 2008). In the previous year 2008, an estimated 1.4 million adults and children died as a result of AIDS in Sub Saharan Africa (UNAIDS 2008). Besides, a growing number of children in Sub Saharan Africa have been orphaned by AIDS (Robson & Sylvester 2007: 260). However, detailed information on the numbers of children directly affected by the HIV/AIDS epidemic is very limited in most countries in Sub Saharan Africa (Bennell 2005: 468). A major part of the problem is that it is often difficult to establish whether a child, parent or carer is ill or has died as a result of an AIDS-related disease.

Another complicating factor is that there is no standard definition of an orphan. Definitions of orphans vary across different cultures and studies. In general, an orphan due to AIDS is defined as 'a child who has lost at least one parent dead from AIDS or AIDS related diseases'. However, UNICEF and UNAIDS have a more specific definition. They define an orphan as a child under 15 years of age: a single orphan has lost one parent, while a double orphan has lost both parents (Foster & Williamson 2000; Brennell 2005; Barnett & Whiteside 2006: 213). For the purpose of this paper, and in line with working definitions in Zambia, an orphan is defined as 'a child below the age of 18 who has lost one or both parents' (Robson & Sylvester 2007: 262).

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The toll of HIV/AIDS on households can be very severe. Although the whole population is affected by HIV/AIDS, it are often the poorest areas of society that are most exposed to the epidemic and for whom the consequences are most severe. In many cases, the presence of AIDS causes the household to break up, as parents die and children are sent to relatives for care and upbringing.

Although the HIV/AIDS epidemic has affected many aspects of social and economic development, this paper focuses on the affect on educational development. The relationship between AIDS and the education sector is circular - as the epidemic worsens, the education sector is damaged, which in turn is likely to increase the incidence of HIV transmission. There are numerous ways in which AIDS can affect education, but equally there are many ways in which education can help the fight against AIDS and generates hope (Kelly 1999: 6-7).[4] The extent to which schools and other educational institutions are able to continue functioning will influence how well societies eventually recover from the epidemic. Or as the director of UNAIDS, Peter Piot, explained it: 'Without education, AIDS will continue its rampant spread. With AIDS out of control, education will be out of reach' (World Bank et al. 2002).

OVCs are less likely to have proper schooling. The death of a prime-age adult in a household will reduce a child's attendance at school (World Bank 1997: 225 in Barnett & Whiteside 2006: 220).[5] The household may be less able to pay for schooling. An orphaned child may have to take on household or income-earning work. Sick adults may have reduced expectations of the returns of investing in children's education as they do not expect to live long enough to recoup the investment. When a child goes to another household after his or his parents' death, the obstacles become greater as the child is not their own (Barnett & Whiteside 2006: 220).

Finally, a reason why it is important to focus on children is that the impact of HIV/AIDS 'will linger for decades after the epidemic begins to wane' (Foster & Williamson 2000: 275). However, for a diversity of reasons, little attention has been paid to the situation and experience of individual children affected by HIV/AIDS. Nevertheless, greater understanding of the impact of HIV/AIDS on children's education is essential in the design and evaluation of programmes to support children living under difficult conditions.

HIV/AIDS epidemic in Zambia

Zambia, in southern Africa, has been severely affected by the HIV/AIDS pandemic and can be seen as 'the mirror of Sub Saharan Africa'. Statistics emphasize that one in five adults is infected with HIV (Kayanta 2004 in Robson & Sylvester 2007: 259-60). Additionally, more than 70% of the population lives in poverty (CSO 2003 in Robson & Sylvester 2007: 260). However, the country is active to implement the Convention of the Rights of the Child (CRC), to achieve the EFA and the MDGs, by eradicating extreme hunger and poverty, to combat HIV/AIDS, malaria and other diseases, to promote gender equality and empower women and to achieve universal primary education.[6] Besides, the country adopted a number of poverty reduction objectives (Ministry of Foreign Affairs 2008: 19).

Almost 50% of Zambia's population is under 15 years old, 71% of children live in poverty, and one in four children are orphaned. In other words, the HIV epidemic has devastated the country and it is estimated that by 2010 there will be 1,328,000 AIDS orphans (UNAIDS 2008). These children are vulnerable to neglect, sexual abuse and early marriages, forced child labour and can have serious health and nutrition problems. As a result OVCs are less likely to have access to school and to complete quality basic education. Social protection measures put in place by the government are hampered by inadequate resources, and OVCs lack of awareness of their rights.

The impact of the HIV/AIDS epidemic on the Zambian education system

The AIDS epidemic affects the supply of and demands for education in a variety of ways, especially in a high HIV prevalence country like Zambia (Bennell 2005: 467). HIV/AIDS has multiple effects on education through ten different mechanisms: reduction in demand, reduction in supply, reduction in availability of resources, adjustments in response to the special needs of an increasing number of orphans and vulnerable children, adaptation to new interactions both within schools and between schools and communities, curriculum modification, altered roles that have to be adopted by teachers and the education system, the ways in which schools and the education system are organised, the planning and management of the system, and donor support for education (Kelly 1999: 1).

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More and more research is carried out on the impact of the HIV/AIDS epidemic in Zambia. However, little research has been undertaken in basic schools themselves, to examine the experiences of poverty and AIDS-affected children. Therefore, Robson and Sylvester emphasize that ´it is timely to explore the perceptions of education personnel and students regarding the adequacy of responses within the educational sector and to identify the unmet needs´ (Robson & Sylvester 2007: 262).

mpact of the HIV/AIDS epidemic on education for pupils

There are three groups of schoolchildren whose lives are most directly affected by the HIV/AIDS epidemic and whose education is, therefore, potentially at maximum risk: children who are HIV positive, children living in households with sick family members, and children whose parents or caretakers have died of HIV/AIDS. The scope to which the education of these children is negatively affected depends deeply on the level of physical and emotional support they get from the extended family, the school, the community and the local government (Bennell 2005: 468).

However, like I explained in the introduction, it is difficult to indicate the number of directly affected children by the epidemic. Besides, schools rarely keep accurate and up-to-date records on the number of affected children and their parents. Nonetheless, we do know that the number of children that is HIV positive because the mother passed the virus on to her child is relatively small, since over 90 per cent of these children die before they are old enough to attend school. It is therefore estimated that a small number of schoolchildren is infected or has AIDS related sicknesses (Brennell 2005: 469). This is also the reason why mortality rates at primary schools are low.

It is commonly believed that the education of children who are most directly affected by the epidemic is adversely affected in a number of ways. The main argument is that given very difficult home situations, both orphans and children in AIDS-affected households are often forced to drop out of school altogether with little likelihood of ever returning to school (Brennell 2005: 473).

The growth in the number of orphans [and other directly affected children] is taxing the coping strategies of families and society at large. In many cases, the extended family find it extremely difficult to cope economically and psychologically with the numbers it is required to absorb. Few orphans [and other children in AIDS-affected households] are able to pay their school or training fees. Many others have to care for others in the homes where they live. Many have to work to support themselves or younger siblings dependent on them (Kelly 2000: 57 in Brennell 2005: 473).

Pupils whose parents die or are ill often drop out of school due to different factors such as, economic stresses on households, changes in the family structure, responsibilities to look after the sick, the elderly or siblings and loss of parental supervision (Foster & Williamson 2000: 278,81). The way school attendance, performance and school completion are effected generally depends on levels of risks and vulnerability due to social, economic and cultural circumstances (Robson & Sylvester 2007: 265). It is important to mention that the financial burden on families, for example when parents die, prevents many children from attending school despite the provision of free basic education because of the extra school costs, like textbooks, contribution to school funds and examination costs (Brennell 2005: 475; Barnett & Whiteside 2006: 220).

Other reasons for children to drop out of school or to perform badly are that poor children are frequently ill because of poor living conditions, which seriously affects their education. Besides, AIDS-related stigmas and discrimination increase the chance that children are not going to school (Foster & Williamson 2000: 281-82; Bennell 2005: 473). Children, especially whose parents are known or suspected to have died of HIV/AIDS face the risk of being stigmatised or discriminated. This can also result in bullying of these children. Stigma and discrimination in schools violates the principles of inclusive education and education for all (Robson & Sylvester 2007: 266).

Research in Zambia showed that the number of children attending primary school is decreasing. The decline in school participation rates was thought to result from poverty, inability to pay the rising costs of schooling, and increasing parental disillusion with the low quality of education. This is linked to HIV/AIDS and its affects on poverty, levels of employment, and the quality of school provision (Kelly 2000: 12 in Barnett & Whiteside 2006: 220). Noteworthy is that proportionately more orphans than non-orphans were not attending school according to this research.

Although it is important to focus on enrolment rates and participation, it is also important to pay attention to the quality of learning as well. Children, for example, might be hungry, or are unable to concentrate due to tensions or anxiety at home. Vulnerable children tend to be more malnourished or to have received insufficient health care. This negatively affects school enrolment, attendance and performance (Robson & Sylvester 2007: 266; Barnett & Whiteside 2006: 221). Orphans and other vulnerable children often have to do a lot of household tasks before and after school. This indicates that obstacles to school achievement are strongly connected with poverty and its related tensions. Besides, the curriculum of the school often not adapts to the vocational, emotional and life skills needs of HIV/AIDS affected-pupils.

What's more, HIV/AIDS has resulted in increasing teacher absenteeism and a significant decline in the number of teachers. This affects the quality of teaching, learning and assessment and diverted resources away from schools. The remaining teachers face problems because the burden on their shoulders increases since they have to manage progressively larger class sizes with poor resources (Kelly 1999: 3; Carr-Hill 2002 in Robson & Sylvester 2007: 261, 265; Barnett & Whiteside 2006: 220). Sometimes pupils are also sent home because of a lack of teachers. All together, this affects the quality of teaching and learning for the pupils.

Overall, we can say that poor pupils attending and performance is the result of a myriad of factors including irregular attendance and generally poor quality of schooling (Brennell 2005: 475). Studies also show that HIV/AIDS should not be excessively blamed for problems achieving Universal Primary Education. Problems with school enrolment, attendance and completion are also related to poverty or problems inherent to the school system, such as the quality of education (Barnett & Whiteside 2006: 222).

Redressing the harmful consequences within the educational system

In Zambia most of the initiatives within the education sector in relation to tackling HIV/AIDS and poverty are situated within educational reform programmes, such as the Basic Education Sub-Sector Investment Programme (BESSIP). The aim of this programme is to increase and improve the access, quality of basic education by the year 2015 (Ministry of Foreign Affairs 2008: 19). Besides, the Ministry of Education made the goal of equitable access to relevant education a right for all Zambians and it removed the school fees in 2003 (Robson & Sylvester 2007: 260). HIV/AIDS prevention strategies tend to focus mainly on preventive community-based initiatives to improve access to health education. However, there are various barriers to learning and participation. This is linked to the fact that many teachers lack the knowledge or the skills to implement effective HIV/AIDS and life skills programmes (Obura & Sinclear 2005 in Robson & Sylvester 2007: 260).

Therefore, the challenge for the Zambian Ministry of Education (MoE) and the international community is not only to provide the right to basic education, but also strengthen schools as inclusive and supportive communities. For the pupils, this might focus on provision of alternative and more opportunities for participation and learning, access to health, life skills, suitable counselling and support in order to cope with the harmful consequences of the HIV/AIDS epidemic. For teachers, it is important to concentrate on professional development opportunities in order to support the management of large scale and curriculum development - e.g. in the areas of life skills and vocational skills (Robson & Sylvester 2007: 259-60).

In Zambia, community schools have a significant position in redressing the harmful consequences of HIV/AIDS within the education system. Community schools try to differentiate the learning needs of OVCs by designing and delivering a relevant and meaningful curriculum that assist these children to develop income-generating skills, personal, health, emotional and social skills, and critical learning skills (Kelly 1999: 4). Most community school use the four-year curriculum: Skills, Participation, Access and Relevant Knowledge (SPRAK). This curriculum offers pupils a 'fast track' to official grade 7 examinations (Chondoka 2004; Robson & Sylvester 2007: 267).

In the following part of this paper I will first explain the main features of community schools in Zambia. Secondly, I will discuss why community schools and especially the SPARK curriculum could be a solution for the educational development of OVCs affected by the HIV/AIDS epidemic.

Community Schools

One of the main characteristics of the Zambian education system is the central role played by community schools. Community schools emerged as a response to the unmet demand for school places among the poor and other marginalised groups in Zambia who are not in formal schools (USAID 2006 in Robson & Sylvester 2007: 262; Ministry of Foreign Affairs 2008: 52). In many instances, these schools are run by parents and volunteer teachers, though increasingly they receive support from the government, non-governmental organisations, faith based organizations or private initiatives. In other words, there is an enormous variation between community schools, more than between government schools or private schools, in how they are supported and managed (Destefano 2006). Besides, the school buildings and provisions vary greatly. A large number of these schools have 'wattle-and-daub constructions' and temporary provisions (Ministry of Foreign Affairs 2008: 52, 56).[7] Classrooms and water and sanitation facilities are often of poor quality. Teaching and learning materials are generally inadequate. Pupils often sit on the floor. Uniforms are often not a school requirement. Finally, the vast majority of teachers are unqualified (Chondoka 2006: 7). Adversely, reasons why these community schools increase in popularity are that community schools are less expensive, close to home, less demanding in entry requirements and are managed by local communities. Most community schools serve children aged between 9-16 years who are either drop-outs or who have 'never been to school'.

The concept of a community school was not entirely new to Zambia. The European missionaries had already established similar schools and called them 'village schools' or 'bush schools' (Chondoka 2006). Around 1995, more community schools began to appear in areas without government schools, where parents could not meet the expense of the high school fees that were charged, where the distance to the nearest government school was to far or where the government schools were considered overcrowded. Since 1998, the Zambian government officially recognises community schools. The Zambian government acknowledges the positive effect of community schools in redressing the harmful consequences of the HIV/AIDS epidemic. Since 1998, the number of community schools has enlarged exponentially, although the school fees for government schools were banned in 2002 with the introduction of free basic education. However, it is important to mention that in general, community schools are relatively small. In 2000, they accounted for 17% of the basic schools and 8% of the pupils in basic schools; in 2006 these figures had increased to 34% and 16%, respectively (Ministry of Foreign Affairs 2008: 54-55). In 2005 the MoE distributed 30% of their budget to community schools (Robson & Sylvester 2007: 262). This made it possible for community schools to receive school grants, textbooks, professional guidance and sometimes a government funded teacher. However, most community schools started without prior information of the MoE and are severely underfunded. While the majority of the community schools receive an inadequate amount of MoE support, many other schools not even receive a school grant. Despite the fact that the MoE supports community schools, its practical interest seems to be somewhat limited. Actual support depends on the specific policy of the particular district boards (Ministry of Foreign Affairs 2008: 54, 56).

Community schools can be found in both rural an urban areas. A recent study shows that the main reason determining the location of rural community schools is distance to the nearest government school (Chondoka 2006: 7). In urban areas, these schools are set up in locations with large concentrations of children who are unable to get access to a public school due to costs or other factors (Destefano 2006).

Pupils in community schools usually belong to the poorest and most vulnerable social strata (Ministry of Foreign Affairs 2008: 54). Less than one third of community school families live in stable structures, compared to 46% of public schools families (Destefano 2006). Most community schools are attended by a relatively large number of orphans. In 2005, about one in three pupils in community schools had lost his or her mother. In government schools this ratio is one in five. Most of the orphans lack sufficient parental support. According to a study in Central Province, many orphans not succeed to come to school regularly, while many of them are to hungry to concentrate in class when they do come (Chondoka 2006: 9).

Due to their restricted size, many of the community schools make use of multi-grade teaching, especially in rural areas. Instead of using the normal curriculum, they most of the times use the SPARK curriculum, which provides primary education in four years. The SPARK curriculum has been designed to meet the particular needs of community school children, who are usually older (between 9 and 16 years) and who are often directly hit by the HIV/AIDS epidmic. It follows the government curriculum and focuses on the relevant topics within English, Mathematics, Environmental Science, Social Studies, Physical Education and Zambian languages, with a life skills component integrated through all the subject areas. The SPARK curriculum places health education, with a strong focus on AIDS/HIV prevention, at the heart of the primary circle. It prioritizes literacy, numeracy and life skills which are recognized as having to serve a nation in crisis due to the young people who will have to survive and assume early responsibility of heading a family due to HIV/AIDS (Ministry of Foreign Affairs 2008: 56).

As this part of the paper tried to make clear, community schools are able to reach the most vulnerable and marginalized groups within Zambia, such as orphans. By using the SPRARK curriculum, that assist these children to develop knowledge and skills, it is possible to adapt to the needs of OVCs who face a lot of challenges because of the HIV/AIDS epidemic. However, it also clear that there is an enormous variation between community schools. It is therefore important that the MoE not only recognises the community school, but also that the MoE support is more fairly distributed between the different (types) of community schools. After all, it is important to work together with the different types of school to achieve EFA goals and the MDG's and to guarantee that all children have the right to education.


One of the most dramatic impacts of HIV/AIDS epidemic is the threat they constitute to the well-being of children and young people. The already high prevalence of poverty, coupled with the possible impacts of the AIDS epidemic can have long-term educational, emotional and social consequences (Khin-Sand Lwin et al 2001; Kanyata 2004; UNICEF-Zambia 2004 in Robson & Sylvester 2007: 268). It is estimated that the majority of children having lost one or both parents due to AIDS is living in Sub Saharan Africa. Children affected by HIV, as well as children living with HIV, often suffer from stigma and discrimination. The opportunity of these children to continue their education successfully may be reduced if their impoverished family or caretakers cannot pay the fees or the extra school costs.

By giving a case study of the impact of the HIV/AIDS epidemic on basic education for orphans and vulnerable children (OVC) in Zambia, this paper showed that relationship between the epidemic and the education sector is circular. There are various ways in which the epidemic effects the education for OVCs, but there are also several ways in which education can generate hope for these children. Schools, teachers and the Zambian government therefore need to be made more responsive to the needs of OVCs. Providing education to these children is not only a human rights imperative, it is also vital to break the vicious cycle of poverty and to promote security and public health. Basic education should, therefore, be free and target support to meet essential schooling costs (provision of lunches, books and pencils, examination fees). Besides, basic education should be provided for needy children as part of a wide-ranging package of support and it could help prevent absence or dropout (Brennell 2005: 487).

To my opinion the Skills, Participation, Access and Relevant Knowledge (SPARK) curriculum, which is used at most community schools, is a step forward to overcome most obstacles to achievement of education. SPARK is a special curriculum that was written for community schools. This four-year curriculum follows the government curriculum with a life skills component integrated through all subject areas and offers pupils a 'fast track' to official grade 7 examinations. However, more drastic curriculum and pedagogical review and teacher professional development are necessary to improve the quality and relevance of the educational experience. This also requires further research of what pupils are learning, and differentiated responses to their particular needs (Robson & Sylvester 2007: 269).


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