Child-headed household support programme


Establishing a new, targeted Child-Headed Household Support Programme will enable UVHAA to extend its valuable HIV/AIDS outreach services and help to build community capacity to care for orphaned and vulnerable children.


Umdoni and Vulamehlo HIV/AIDS Association (UVHAA) has a vision of people in the rural areas of Umdoni and Vulamehlo accessing basic health services and income-generating opportunities, and living healthy, productive lives. UVHAA engages in multiple outreach programmes that respond to the impact of HIV/AIDS and poverty on rural communities in KwaZulu-Natal.


Since 2002, UVHAA has been successfully implementing outreach programmes to people affected and infected with HIV/AIDS in the communities of the Umdoni and Vulamehlo municipalities, which are located in deeply rural regions of Southern KwaZulu-Natal. These remote communities have one of the highest HIV prevalence rates in the country. A staggering 40.2 % of people are estimated to be infected with HIV, and about 10% of these have full blown AIDS. The effect on children has been devastating and it is estimated that there are as many as 3,000 orphans living in the area. There are few services available to help these children and the number of young orphaned children living alone has increased dramatically. Through this project, the Child-Headed-Household Support Programme will identify and support 120 child-headed households in the first year, 240 in the second year and 360 in its third year reaching an estimated 1500 children. The existing home-based care network will be expanded and a team of trained area coordinators, home-based carers and a qualified social worker will conduct household assessments, provide emergency assistance, help children to access government grants and financial support and provide children with ongoing psycho social support. The presence of this targeted intervention for orphaned children will help to strengthen the communities’ capacity to care for them.


  • This project expands UVHAA’s existing, successful HIV/AIDS services in highly vulnerable, under-resourced communities.
  • The establishment of a targeted child-headed household support programme can help to create a more supportive community environment for orphaned and vulnerable children through advocacy, education and mobilisation.
  • The project aims to strengthen the capacity of child-headed families by providing for emergency relief, economic, psycho social and other ongoing support. The emergency relief will mitigate threats to their basic survival and regular monitoring will help mitigate threats to their security, preventing exploitation and abuse.
  • The UVHAA home-based carers and social worker will help these children to access essential services including education, health care, birth registration and social grants.


An investment of R491,200 over one year will enable UVHAA to establish its Child-Headed-Household Support Programme in the communities where it operates. No such services exist in an area where there are estimated 3000 orphans, many of whom are not fostered in the community.

  • 120 child-headed households with an estimated 500 children will be reached each year.
  • Direct life change at R982.40 per person per year. This excludes the benefits to the communities in the building of capacity to care well for orphaned children. This project has breadth depth, intensity and permanence in its positive impact on the physical, emotional, psycho social, economic and social aspects of the beneficiaries’ lives.


Through its Home Based Care programme, UVHAA has witnessed an increasing number of HIV/AIDS-related deaths and a staggering increase in the number of orphaned children who have no one to care for them. In many instances, these children are isolated and their living conditions are not overseen by caring adults. It is estimated that there are around 3,000 orphans in living in the region. In this very rural area, support for child-headed families is dependent on assistance being given where they stay. Government departments are located far away and are largely inaccessible. Dire poverty affects children’s chances at survival and the lack of adult care makes them highly vulnerable to abuse. Older siblings often drop out of school because they are overwhelmed by the need to support younger family members.


  • Identify child-headed households in the area and create a database.
  • Conduct an assessment of children living in 120 child-headed household each year to identify their most urgent needs and ongoing needs for support.
  • Provide emergency assistance, including food, clothing, school fees and uniforms and respond to their medical needs.
  • Assist children living in child-headed households to access financial support through appropriate government grants.
  • Provide ongoing psycho social support to children including bereavement counselling.
  • Ongoing monitoring of the child-headed households in the programme and the building of community capacity to care for them through advocacy.



UVHAA’s network of home-based carers, area co-ordinators and a social worker will be expanded and mobilised to identify and assess child-headed households. Each year, 120 of the most vulnerable of these families will be selected for inclusion in the programme.


Child-headed households will be visited regularly by their home-based carer. A needs-specific support plan will be devised and implemented for each household. Interventions include emergency relief, food security, accessing schools, attending to medical needs and accessing social grants so that the households can ‘graduate’ from emergency relief.


The UVHAA home-based care network has an effective monthly reporting system that includes records of all home visits and interventions. Area co-ordinators monitor the home-based carers on an ongoing basis. UVHAA compiles monthly reports on all activities.


Key Strengths

  • Concept: The idea of expanding UVHAAs home-based care services to include orphaned children in child-headed homes ensures that the organisation provides its communities with more intensive HIV/AIDS related services. It is known that targeted child-headed household support programme can enhance the safety and well-being of orphaned children in their communities. The programme has potential to build capacity in the community to properly secure and care for the increasing numbers of orphans in their villages.
  • Design: The expansion of the existing, familiar and accepted UVHAA home-based care to include the monitoring and support of child-headed households has the benefit of drawing on well-established community relationships and support to underpin the programme. The UVHAA Child-Headed Home Support programme aims at meeting orphans' educational, nutritional, medical, psycho social and economic needs in the short-term and building their self-reliance in the longer term.
  • Capability: UVHAA has committed, focused, skilled leadership well-supported by an active, diverse and involved Executive Committee. UVHAA has demonstrated its depth and expertise in delivering effective health care services in the communities in which it operates.
  • Control: The organisation has established systems in place for proper management, reporting and regular external auditing of its finances.
  • Sustainability: The organisation and its services are well-established and valued in its communities. There is strong anecdotal evidence that the organisation makes a lasting positive impact in the lives of their beneficiaries through their HIV/AIDS related programmes.

Key Risks

  • Capability: UVHAA is highly dependent on a key individual to drive the organisation and the implementation of a succession plan is required to mitigate the risks associated with this dependency. UHVAA is a voluntary association and in the main, draws on the expertise and involvement of a number of retired individuals on its Executive Committee.
  • Sustainability: Once data collection has been done, it may show that the three year project is not to scale and expansion will be required to meet actual needs of the child-headed homes. Any organisation working to support children orphaned due to HIV/AIDS is challenged by the fact that they will have to sustain themselves over the long term to keep meeting the needs of increasing numbers of children. UVHAA will have to secure ongoing funding to sustain this programme into the future.
  • External: There is a low risk of unexpected dissent in communities which could adversely affect the programme.

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Project Profile




Umdoni and Vulamehlo HIV/AIDS Association






12 months


ZAR 491 200





Project Location

Project Risk

Organisation Rating

Project Budget

Over 1 year
Project operating costs
Project Coordinator (part-time)36,000
Area Coordinators (5 part-time)90,000
Social worker (part time)60,000
Driver (part time)18,000
TOTAL Salaries204,000
Insurance and tracking for 1 vehicle9,000
Maintenance and petrol12,000
Transport allowance for home visits18,000
TOTAL Transport39,000
TOTAL Direct emergency assistance to Child-Headed Households (30 households at R550/month)198,000
Bank charges2,400
Staff training and evaluation1,200
Administrations, Tel, Fax and stationery6,000
Air time for field staff6,000
Contingency fund2,500
TOTAL Other18,100

SASIX Administration32,100

TOTAL project budget:491,200


South Africa has one of the highest prevalence rates of HIV/AIDS worldwide, with at least 5.5 million people estimated to be infected with the virus. Women of childbearing age are particularly vulnerable to HIV/AIDS and to the transmission of the virus to their children. UNICEF estimates that 240,000 children under 15 are infected with HIV, with many more orphaned or made vulnerable by the disease.

The National Department of Health’s Operational Plan commits to providing antiretroviral (ARV) treatment to all South African citizens, but critics say a lack of political championing and uneven delivery of health services leave many communities without effective programmes in prevention, treatment and care. Recognising the urgency, civil society and many private sector companies have pioneered major initiatives, including political campaigns for access to life-saving antiretroviral treatment, awareness and education programmes, home-based care programmes, daycare and after-school centres, and programmes promoting voluntary testing and counselling as well as treatment and access to medical care.

The problems caused by AIDS have far-reaching consequences for human development in any society. The ripple effects begin with the family, followed by the community, and the nation at large. According to the United Nations Children's Fund (2005) an estimated 1.2 million children in South Africa have lost at least one parent to AIDS and this number is expected to reach over 2 million by 2010. With the economically active group hardest hit, both individual enterprises and the economy as a whole suffer the consequences of widespread illness and death.

SASIX offers investment opportunities in HIV/AIDS projects by social profit organisations, including projects that – focus on education and awareness to help to prevent the spread of HIV, promote gender equality and reduce the vulnerability of women and girls to infection, promote voluntary testing and counselling, promote access and adherence to antiretroviral treatment, respond to the needs of orphaned and vulnerable children, provide training and counselling for community members involved in home-based care, assist organisations to strengthen their capacity and outreach, and advocate for and protect the rights of people living with AIDS and their families.


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We use a comprehensive selection and evaluation process to assess SASIX projects. When evaluating an organisation's overall risk profile we look at:

Concept - the project's approach to addressing the need.

Design - the use of effective and proven methods.

Capability - the organisation's leadership depth and expertise.

Control - transparency, governance and financial management.

Sustainability - lasting impact.

External - factors outside of the organisation's control.