Lack of ability to measure factors such as food security, housing, wellness and education has resulted in scores of children in severe distress not being covered by development projects, said Jonathan Simon, Chair, Department of International Health, Boston University School of Public Health.

He was making a presentation on ‘Challenges in serving children infected and affected by HIV/AIDS: opportunities for India to improve health systems to deliver effective programmes,' at Voluntary Health Services here on Monday.

Household economic strengthening is crucial to dealing with poverty and, essentially, the services for children infected and affected by HIV/AIDS.

While at the moment, there are many single orphans in India, or children who still have one parent, Prof. Simon predicted that the country would be seeing more double orphans as the epidemic progresses.

The question of the community's role in supporting these children would also come into question, if the numbers rise constantly over the years.

Studies in Africa had shown that most guardians of orphans and vulnerable children expressed concerns about developmental delay in children. Malnutrition was a serious concern. In this context, India, with its mid-day meal project, was a global leader in alleviating hunger and malnutrition, he said. Acknowledging the role of civil society organisations as key actors in the process of delivering care and support, and the role of public private partnerships, he warned that the mix must be right for it to work. Also these organisations often lack organisational and human capacity to maximise impact, Prof. Simon said. Meeting the human resource crunch is definitely going to be a problem in future.

Hinting at the huge finances required to meet the challenge, he explained that true costs were often greater than financial costs to the donor. Could these funds be supplemented by the community?

Another factor that worried Prof. Simon was the lack of adequate tools to monitor programmes currently. It was essential to create mechanisms to effectively keep a watch on the efficacy of such interventions.

Bimal Charles, project director; Gayatri Mishra Oleti, director-Strategic Planning and Partnerships, AIDS Prevention and Control Project, VHS; and P. Manorama, founder, Community Health Education Society, spoke.

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MeetSeptember 24, 2010