Mmbando Paul, Hartwig Kari A, Hofgren Berit, Disorbo Phil, Smith Shelley, Hartwig Kristopher N
Evangelical Lutheran Church in Tanzania, PO Box 3033, Arusha, Tanzania.
J Health Care Poor Underserved. 2009;20(4 Suppl):13-21. doi: 10.1353/hpu.0.0195.
In the fight against HIV and AIDS in sub-Saharan Africa, the plight of orphaned and vulnerable children was long overlooked. The first United Nations report on orphans and vulnerable children did not emerge until 2002 after more than two generations of children and youth had struggled to survive with limited family, institutional, or government support. The major social determinants of health for infants and children with one or more parents dying or dead from HIV include pervasive poverty, weak community social support systems, lack of policy commitment by governments or foreign donors, lack of access to anti-retroviral drugs, limited access to schools, and gender. In this paper, we present a model of care and support to the most vulnerable children (MVC) affected by HIV that brings together faith-based institutions in partnership with the government and community volunteers in 13 rural districts of Tanzania. Although still being implemented, the project has a number of valuable lessons learned for program managers, donors, and researchers working with faith-based organizations in the development and delivery of services to the most vulnerable children in a resource-limited setting.
在撒哈拉以南非洲抗击艾滋病毒和艾滋病的斗争中，孤儿及弱势儿童的困境长期被忽视。直到2002年，在两代多儿童和青年在有限的家庭、机构或政府支持下艰难求生之后，联合国才发布了首份关于孤儿及弱势儿童的报告。父母一方或双方因艾滋病毒死亡的婴幼儿的主要健康社会决定因素包括普遍贫困、社区社会支持系统薄弱、政府或外国捐助者缺乏政策承诺、无法获得抗逆转录病毒药物、上学机会有限以及性别因素。在本文中，我们展示了一个针对受艾滋病毒影响的最弱势儿童的关爱与支持模式，该模式将坦桑尼亚13个农村地区的宗教机构与政府及社区志愿者联合起来。尽管该项目仍在实施，但它为项目管理人员、捐助者以及与宗教组织合作在资源有限环境中为最弱势儿童提供服务的研究人员提供了许多宝贵经验。
