LITERATURE REVIEW

2.0 Introduction

In Kinawataka, there are more than 200,000 children orphaned by AIDs, not including the other population of children whose parents are terminally ill. While overall school enrolment rates have risen to approximately 50% in the whole of Kampala district, AIDs affected children have been systematically left behind. According to the Center for Disease control, there are about 150,000 orphans in Kinawataka. When children become orphaned, it is a new beginning for which no one, none the last children are prepared for. For a majority of these orphans, this could mean going to stay with a member of extended families, grandparents, foster parents, and child headed homes. Dropout from school or failure to enroll is the grossest manifestation of impacts of orphans on education. According to Reach out Mbuya HIV/AIDs initiative (NGO), international evidence indicates that orphans tend to have lower enrolment rates than children with both parents alive and their disadvantage can be substantial-around 30% lower or worse. Impacts seem to vary widely, depending on social, economic and cultural circumstances. Household income may be a stronger predictor of non-enrolment than orphan status per say. It is also reported that poverty forces many children to drop out of school.Kinghorm, A (June 2002) also reported girls are more likely than boys to drop out of school or be forced to stay home because of financial limitations.

In Kinawataka, there is limited data on orphan dropouts and attendance rates. However, there are strong indications from qualitative work and the school survey hat a significant number of orphans are affected by drop put. In a research conducted by Human Right Watch (2005), 29% of the learners sampled knew children who had dropped out for over a month after a parental death and 26% know of permanent dropouts after parental deaths. Among teachers, 11% said that parental death was an important reason for dropping out of school. Anecdotal reports of good learners who had dropped out after parents died were common.

As reported in human right watch (2005), previous survey found that significant numbers of dropouts independent of HIV/Aids are due to factors associated directly or indirectly with levels of parental support, a cause for concern.

Children leave school to perform household labour to believe their parents’ death. Many cannot afford school fees because their surviving parent is too sick to earn a living or their grandmother or foster parents cannot afford school development fees and uniform.

Dropping out of school exposes orphans to lifelong cycle of property and abuse. Children who drop out of school face a high risk of sexual exploitation, hazardous labour, and living in the street.Hasnaim, M, in cultural approaches to HIV/AIDs Harm reduction in Muslim countries (2005), reported that, effective counseling and education have been shown to change sexual behavior and reduce the risk of HIV transmission even in high risk groups.

Orphans have reduced demand for education in several ways. The loss of wage earners in the family can reduce it to povert.Spporting the direct and indirect costs of education becomes increasingly difficult as medical and funeral expenses absorb family resources. Human Rights watch(2005,p10),mentioned that surveys in highly AIDs-affected areas in numerous countries have found that orphans are less likely to attend school than non-orphans; less likely to be at the appropriate grade given their age, and more likely to have their schooling interrupted. In 2003, based on demographic data from 31 countries, and reported by Human Rights Watch (2005), UNICEF concluded that orphans are less likely to be in school and more likely to fall behind and dropout. However, it’s not just the lack of financial resources that will keep orphaned children out of school. Even if orphaned children enter school, the chances of them completing their education are slim, this is due to the fact that many children will need to work or care for the sick adults. They may also be ostracized, discriminated against and suffer from stigma when it is known that their family members have HIV/Aids. Some children are HIV positive will also be too ill to attend school.

Providing care and support for orphans has emerged as one of the biggest challenges, Kinawataka faces today, as the growing numbers overwhelm available resources. As reported by the center for disease control and grant and application for inclusion in the program is ever growing. The number presented above does not include the children who are directly supported by NGOs notably, catholic Aids Action and Church Alliance for orphans.Aids,fuelled by poverty levels, is one of the main contributors to orphans incidence in Kinawataka.

Many literature facts support schools and teachers’ perspective on AIDs orphans dropping out of school. Some of the reasons are presented below;

2.1 Relationship between AIDS and school dropout

Beegle et al (2006) discuss the major risks related to orphan hood, where poverty in adulthood is a main concern, primarily due to the shortfalls in human capital investments. The HIV/AIDS pandemic has made a marked increase in orphan hood in sub-Saharan Africa and this is expected to influence the schooling out comes for these children. There are different theories concerning the educational differences between orphans and non-orphans. Sharma (2006) discusses some theories on why orphans might fall short in comparison to non-orphaned children.

First, it may be more likely for orphans to live in poorer households compared to non-orphans. If there are credit constraints, the labour allocation within the household where a parent has died is therefore likely to be reallocated in order to obtain additional income to meet consumption needs. In other words, there are new responsibilities as well as a changed family structure and thus the investment in education may decrease. Sharma (2006) stresses the far distance to the future financial return of education as an essential argument for families bringing their children out of school. The opportunity cost of having these children in school is simply too high

Trauma from the death of parents and the loss of parental guidance and support, especially in the presence of HIV/AIDS, may lead to the child being unable to perform in school and in turn, affecting the decision to attend school (Sharma 2006). Shimamura and Carter (2011) add that orphans are likelier to repeat grade levels in school because they have experienced a parental death and its consequences. This might lead to an interruption of human capital accumulation and the orphan’s educational progress may lag behind. This delay in educational progression can then affect the orphan’s schooling decisions in a negative way. The AIDS-related stigma is also believed to affect orphans in their decision to return to school. Furthermore, losing a parent is a grieving process and some children may never stop grieving, which is likely to affect their schooling decision as well as their future (Boler & Carrol 2003).

As the HIV/AIDS pandemic has spread through sub-Saharan Africa, there has been a surge in the interest for its consequences on society. This has resulted in a lot of research related to the socio-economic impacts of HIV/AIDS.

Orphans are some of the most severely affected by the pandemic because they have lost one and sometimes even both parents at a young age. Education is considered the most important type of investment in human capital (Weil 2013 p.178) and is believed to impact economic growth as well as democracy in a number of ways, such as, through higher wages, increased productivity and more efficient and honest governments. This is part of the explanation as to why orphans’ education has been a hot topic for researchers over the past decade. In this section the aim is to provide an overview of the previous research analysing the education of orphans in Africa.

Lack of scholastic material affects a child’s stay in schools, Faced with an increasing burden of children affected by AIDs, many schools in sub-Saharan Africa are taking modest steps such as establishing “AIDs Clubs”, introducing HIV-prevention education, and providing occasional counseling to orphans and other vulnerable children. However, in most cases documented by Human Rights Watch (2005), schools proved ill-equipped to address the complex hardships faced by orphaned children. The case of ill-equipped schools is so common in Kinawataka region as this is evidenced whereby there are a few schools but with a very big number of pupils who don’t have enough equipment to conduct their studies.

Lack of parental support weakens the ability of children to stay in school, Geoff and John, (2000) and Human Right Watch (2005) separately found that Child-headed households were cited as a cause for orphans dropping out of schools. Regular attendance in school proved next to impossible in this case, unless the household was receiving significant charitable support. It was reported in Human Watch Report (2005) that “the first-born of five children in Kampala, said she lost her mother to HIV/AIDs when she was seventeen. Her mother had just given birth when she died, and she dropped out of school to care for her baby sister and three other siblings.

Inability to afford schools fees and or school uniform and other prohibitive costs as textbooks, and examination fees preclude orphaned children from attending school. Indeed, numerous children identified inability to pay for school fees or related costs as the proximate cause of their withdrawal from primary school.Luvuma M in an interview with Reach out Mbuya said “I’m selling water, so I can supervise and support my younger siblings who still attended school “he dropped out of school when his parents were sick and never returned to school since then.

Poor household income in AIDs affected homes has direct impact on school attendance by students 15-20years old was cut in half in households that lost an adult female in Uganda (World Bank,1995).It was found that 31% of households interviewed had a child who was not attending school following the death of the mother.

This result was confirmed by the World Bank which found out that 30% of AIDs-affected households in the suburbs of Kinawataka were unable to meet the costs of their children’s’ education because of AIDs.

The educational situation of orphans varies from one country to another. According to Eric,(2003) the effects of poverty are such that in sub-Saharan Africa, children aged 5-14years who had lost on or both parents were less likely to be in a school and more likely to be working more than 40hours a week than children with both parents.

HIV/AIDS orphan face Poor Health and Malnutrition, this lowers their chances of completing secondary school education, AIDs orphans and vulnerable children stand an increased chance of being malnourished and receiving inadequate medical care. A close correlation was reported between child morbidity and the quality of parenting. Fostered children in West Africa experienced higher mortality than other children because of poorer care, malnutrition and reduced access to modern medicine. It might be expected that the health of orphans, especially those in the care of elderly and adolescent caregivers would be worse than other children; substitute caregivers may be uninformed about good nutrition, oral rehydration treatment for diarrhea and the recognition of serious illness observed. Children that are malnourished have reduced resistance/defense against many common infectious diseases. Thus when they become sick regularly, their school work falls behind and eventually drop out of school. Thus, poverty and attendant malnutrition and ill health become barriers to attendance and educational quality.

Stigma and discrimination associated with the HIV/AIDs epidemic lead to irregularly school attendance and eventual dropout from school. The stigma associated with HIV/AIDs is causing aids affected learners being taunted by their peers. Human Rights Watch (2005) reported an instance involving an eight year old boy whose school fees were subsidized by The AIDs Support Organization (TASO) in Uganda, said that his classmates and teachers nicknamed him “TASO child” and treated him differently from other children. Charles also recalled “My classmates, they knew as “the son of Aids, “and teachers and students would call me TASO child”, when we were sharing desks, the kids wouldn’t want to sit next to me.

2.2 Effects of HIV/AIDS on children school enrollment

Due to loss of parents bat a young most of the guardians are always cruel to the children, according to Human Rights Watch (2005), Children affected by HIV/AIDs may be subjected to impersonal and abusive child care through exploitative family and community care, poorly chosen and supervised foster care, and long term institution-based rearing. Some care givers favour the education of their own children over the education of AIDs orphans in their care, this sometimes prevents children from enrolling in schools education. In general, and without considering associated effects such as pre-existing home conditions, separation and bereavement, impersonal and abusive care is associated with a range of psychological disorders, including a reduced capacity for affection and compassion, acting out and more aggressive coping styles. Richer (2003, p.24).

Children often migrate to their relatives places in case of loss of parents this affects their education cycle and prevents them from enrolling to schools, Richter (2003, p.10), observed that, migration has been identified as an important family and community coping mechanism in the face of the HIV/AIDs epidemic. This is especially so in northern Uganda. Migration occurs for several reasons and people move both within and between rural and urban areas. Some identified forms of migration include going-home-to-die, rural widows moving to town to seek work or help of relatives, and potential caregivers and dependents moving between kin households to achieve the most optimum care arrangements for all concerned. Children are frequently relocated, adolescents are particularly affected by migration. Children of school going ages might not find schools in their new locations; in some cases the new foster parent is unable or unwilling to sponsor the education of these orphaned children.

Human Rights Watch (2005) documented numerous cases of children dropping out or falling behind in school when their parent became ill and unable to care for them due to HIV/AIDs. In Uganda, Martin P. said he lost his father to HIV/AIDs when he was twelve and his mother four years later. When their mother was sick, he and his sister took turns leaving school to take care of her. “When mother was sick, it was us who were looking after her… I left school for one term and then went back.” Then my sister left school for one term, and we traded back and forth like that. But even when I was in school, it was not good, because my mind was back with my mother it was not easy to concentrate on my studies.

United Nations Children Education Fund (UNICEF, 1999); MOES, (1995); Government of Uganda (GOU, 1999) Horn (1992); all demonstrate that Parental decisions do affect children retention. Students whose parents monitor and regulate their activities, provide emotional support, encourage independent decision making and are generally more involved in their schooling are less likely to dropout of school (Astone and McLanalan, 1991; Rumberge et al., 1990; Rumber 1995; Odaga and Heneveld, 1995; and Russel, 2001).

Taking into account of the gender dimension of dropouts, UNICEF, (2005) notes that girls are more likely to drop out of school than boys and that pupils whose mother’s have not attained any level of education will most likely dropout of school.

Poverty and inequality cause many child protection deficits. For example, where children are engaged in the worst forms of child labour, this is usually the result of widespread chronic poverty. Social norms and attitudes in families and parenting also play a strong role, upholding a culture of impunity for perpetrators of violence against children. However, domestic violence and other forms of abuse experienced by children are a result of more serious, systemic elements, including but not limited to: complex and poor law enforcement; lack of trained personnel to handle cases of violence; barriers to accessing care; and lack of coordination among sectors responsible for child protection (MoGLSD et al., 2014).

In terms of preschool and primary schooling, Uganda has achieved some noteworthy targets, with no gender gap in access to ECD centres and gender parity at primary level. But other inequalities remain. In 2011, the proportion of children who had never attended school was more than twice as high in the bottom wealth quintile as in the top quintile. Most ECD centres are in urban areas and the Central region, contributing to geographic as well as socioeconomic disparity in access. Despite solid progress in increasing primary enrolment, there remain major inequalities in access between regions and depending on a child’s social identity (children with disabilities and orphaned children are often unable to attend school). Primary school enrolment rates are lowest in the Northern region and in rural areas, with the gap increasing at secondary school level. Girls are also slightly more likely to have never attended school or to have dropped out. Moreover, of the 1.22 million children with disabilities in Uganda, only 5% are able to access education within an inclusive setting in regular schools (Riche and Anyimuzala, 2014).

Income poverty contributes to some of the deprivations that children face. However, a child can be deprived even when the household income is above the poverty line. The Situation Analysis of Child Poverty and Deprivation in Uganda report measures multidimensional poverty and captures deprivation in seven dimensions: nutrition, health, water, education, shelter, sanitation, and information (MoGLSD et al., 2014). This showed that about 55% (3.7 million) of Uganda’s under-five children and 38% of 6–17-year-olds are deprived in at least two poverty dimensions. Children aged 0–4 years whose mother has no education are five times more likely to live in extreme poverty than those whose household head has secondary education. Child poverty rates for 0–4-year-olds are highest in West Nile and Karamoja, where 68% are in poverty. For children aged 6–18 years in Karamoja, the percentage of those living in extreme poverty is even higher (82%) (MoGLSD et al., 2014). Child poverty is lowest in the south-west of the country where 41% of children below five years live in poverty.

2.3 Strategies for improving the livelihood of people with HIV/AIDS

Priority programme for the Poverty Reduction Strategy Paper (PRSP). A National Aids Control Committee (NACC) was instituted in 1998, to co-ordinate all activities geared towards prevention, treatment and care of PLHIV. It also monitors the spread of the pandemic and controls the finances that are allocated to all stakeholders in the fight against HIV/AIDS. ARV drugs have been subsidized over the years beginning with a 53%subsidy in 2002. Cameroon also developed national treatment guidelines and a multi-sectoral plan for decentralizing the provision of ARV drugs in 2004-2005 in collaboration with the NACC and WHO, (WHO, 2005). Early in 2007 the distribution of ARV drugs was declared free by the government, as a result of subsidies from the Association Esther France and drugs for opportunistic infections from the Clinton Foundation HIV/AIDS Initiative (CHAI).

Mbanya, Martyn & Paul (2008, 5) state that the Government of Cameroon has achieved quite a lot in its strategic plans towards curbing the spread of HIV.

These interventions have been very timely to reduce the impact and especially the social burden on people infected and affected by HIV/AIDS. The 2008 progress report by the NACC reveals that 50,005 patients are on treatment, thus representing 55% of patients eligible for treatment. This represents 9,8% of the total number of people living with HIV/AIDS (NACC, 2008). The National Strategic AIDS Plan (2006-2010) addresses the full range of HIV/AIDS strategies, including care, prevention, support and treatment. The government is committed to promoting universal access to treatment, prevention and voluntary testing and counselling (VTC) centres have been integrated into all, regional and district hospitals in all ten regions of the country.

The UNAIDS Cameroon (2008) country report concludes that there is less emphasis on national prevention programmes and much attention is focused on treatment and care of PLHIV. A report by the International Planned Parenthood Federation (IPPE) indicates that HIV/AIDS is still a problem in Cameroon especially for young women and girls. They further that stigma and discrimination is a distinct problem in Cameroon. (IPPF, 2007.).

Globally, HIV AIDS is the second most common cause of death among the youth. It is estimated that in 2007,there were 2 million people under 15 years living with HIV and AIDS (UNAIDS, 2007). AIDS is a serious condition in which the body’s defense against some illnesses is broken down. This means that people with AIDS can get many different kinds of diseases which a healthy person’s body would normally fight quite easily (UNAIDS, 2009). As a result, more hours may be spent out of class due to illnesses thus leading to poor academic performance.

The age group 15-19 years old constitutes 35 per cent of all AIDS cases and an estimated 41,000 youth had contracted AIDS by the year 2000 (UNAIDS,2000). This age bracket is found in secondary schools. According to the District Development Plan (DDP, 2002), the prevalence of HIV and AIDS scourge in Samburu stood at 21 per cent in 2001, having risen from 14.8 per cent in 1996.For a variety of reasons such as under recognition, under diagnosis and under reporting, the actual number probably exceed what is in the records.

According to the report by International Development Consultants and MOEST (2001), HIV and AIDS affect the sector supply through increased learner psychological stress, morbidity, sickness, absenteeism and mortality. “Because of the above over-arching impacts on the education sector, HIV and AIDS is, by far, the most compelling exogenous threat to attainment of Goal number two of the United Nations Millennium Development Goals; Education-for -All by 2015.” (Daily Monitor August 2010). Recent studies have shown that HIV and AIDS have a direct negative impact on the learners in schools. The learning activities are continually interrupted by sickness, repeated occasions the system becomes unable to protect the body against common and otherwise unthreatening diseases, AIDS may be diagnosed. The belief in witchcraft which is engraved in the Samburu culture militates against seeking medical attention. Learners in schools have their lives and subsequent behaviour coined around their cultural practices. Many cultural practices reveal various social dilemmas which need careful thought and serious attention in an attempt to resolve them as well as in then formulation of policies on the management and control of HIV and AIDS (UNAIDS 2001).

Ending of corporal punishment, Corporal punishments and harassment destabilize pupils and prevent them from completing their school. They do not lead to school dropout alone but also expose them to physical and psychological dangers. It is however sad to note that even after introduction of UPE programme, corporal punishments like heavy beating, digging ant-hills and slashing bushes still exist which compromise equality of survival for pupil’s in schools. This is just a sample of the incidents in UPE schools but the story is that corporal punishments threaten many pupils in schools which make them run away forever and never to return in school anymore. Although sexual abuse and harassment is a crime and discouraged by law in Uganda, several reports in the press still show sexual abuse by male teachers on female students. This makes many young girls to get unwanted pregnancies and others get intimidated by their teachers, a reason that explain girls’ dropout more than boys (Kakuru, 2003).

Poverty reduction in orphan hood households, this is by helping the families who have lost their members on HIV/AIDS and providing them with the necessary facilities, Njeru and Orodho,(2012). The two writers consent that the critical factors that are responsible for the low access and poor participation and retention in education is poverty. High rates of poverty at household level have made poor households either not to enroll their pupil’s in primary schools or fail to sustain an uninterrupted participation of those who are enrolled due to inability to meet various requirements.

The above statement is supported by the UNESCO background paper which poses that poverty cannot be overcome without specific, immediate and sustained attention to enhancing access to education (UNESCO, 2002). Poverty is thus addressed in two avenues. First, inability to meet indirect costs for schooling, such costs are school learning and teaching materials, uniforms, transport to and from school and food Several studies done in Malawi, Ghana, Zambia, Ethiopia and Tanzania have shown that pupil’s are hindered form effective participation in schooling due to inability to afford such costs (Kelly, 2007).

Briggs, (1980) cited in Mbai (2004) contends that poor families may contemplate bearing the cost of sending their pupil’s to school but might abandon the whole exercise when more exercises are demanded.

Fighting against child labour , this is because most of the orphans after loosing one of their parents they tend to concentrate on taking care of their family members and as a result they tend to take up the role of taking care of their family members, according to Mutegi (2005) conversation of the rights of the pupil’s defined a pupil’s as anyone below the age of 18. Pupil’s labor is destroying a generation of pupil’s. Pupil’s who start working when they are young never grow as they miss out on education. The Koech Commission TIQET (1999) also found that pupil’s labor is a rampant practice that continues to keep pupil’s out of school, especially in the prevailing situation of poverty at the household level. Pupil’s in different parts of the country are involved in activities such as fishing, picking of coffee, tea, Mira, hawking and petty trading. In addition many school age girls are employed as house girls and pupil’s menders in urban and rural areas. This habit contravenes the pupil’s rights as stated below “every pupil’s shall be protected from economic exploitation and any work that is likely to be hazardous or to interfere with pupils’ education” (Pupil’s Act, 2001 pg. 153).

Reduction of Birth rates: Birth order also affects schooling. We may start with the premise that a large number of pupil’s in a household has negative causal effects on the quality of education. This is because given equal resources; parents with more pupil’s have fewer resources to commit per pupil’s than parents with fewer pupil’s. Park and Chung (2007) found a strong but negative causal relationship between sib ship size and education of the first-born and second-born pupil’s in rural Bangladesh. Using evidence from the Turkish Demographic and Health Survey, Kirdar et al. (2007) also concluded that birth order affects schooling, to the detriment of the middle pupil’s. They found this impact to be more pronounced in poor families, and they maintain that scarce financial resources are the underlying cause of this birth order effect.

2.2 Summary

This chapter explains the different views of other scholars about effects of HIV/AIDS on school drop out of orphans. In this chapter, many authors, scholars and other intellectuals give their views on how HIV/AIDS has played its roles in the dropping out of children from school.

For example, some schools are ill-equipped in terms of qualified teaching stuff, furniture for the children to use and also lack of enough necessary and important books in the school libraries. This alone can also trigger school drop out of children especially those that lack enough supervision from their caretakers. Lack of parental support was also another point discussed in this chapter whereby Geoff and John, (2000) and the Human Rights Watch (2005) separately found out that child-headed households were cited as a cause for orphans dropping out of school. In such homes, regular attendance of children at school was almost impossible unless the household was receiving charitable supervision. The Human rights Watch quoted that in Kampala, a young girl at the age of 15 lost both her parents to HIV/AIDS and so she was left with the task of raising her four siblings alone which in the end forced her to drop out of school because she had to look for a job and work in order to be able to take care of her siblings who also later dropped out of school due to lack of enough close supervision.

In summary therefore, different factors according to different scholars have sparked off children dropping out of school although this is mostly attributed to HIV/AIDS as the major trigger to such cases as discussed.