Children and the Malawi government

Children need various types of support ranging from those things necessary for survival, such as food and health care, to those interventions that will provide a better quality of life in the future such as education, psychosocial support and economic self-sufficiency. In an ideal world all children would have access to all types of high quality services. In the real world many children, orphaned and not, are malnourished, sick and without shelter. Some argue that a comprehensive programme to support children should include all essential elements including food, health care, education, clothes, shoes, bedding, psychosocial support, economic self-sufficiency, etc. Others hold that some of these elements are not ‘essential’ or far exceed the situation of most children living in poor households with both their parents.
Each country will make its own decisions about what types of support to provide in light of the availability of funding, level of need and socio-economic situation. In this analysis we provide estimates of resources needed for six categories of support:
• Food: Food and clean water are the most basic need for all children. Food supplied from external sources could actually reduce food security in the long run if it disrupts the local market, but food procured locally or produced through community gardens can contribute to local food security. Food may be provided as either bulk grain needing preparation or as cooked meals.
• Health care: The need for health care includes childhood immunizations and vitamin supplements for children under five, routine health care for all and reproductive health services for older children aged 10–17. In some countries health care is free for all children or for the youngest children. However, patients often have to pay for drugs and supplies. Some have argued that orphan-related programmes should advocate for free health care for all children rather than focus on providing funding to pay for care for children. However, in that case additional resources would need to be made available to governments to provide free care to families.
• Education: This includes school fees where they exist, funds required for uniforms, books and other supplies, and special fees. Many countries have eliminated school fees and additional advocacy efforts could help to eliminate them in other countries as well, but the extra costs of uniforms, supplies and special assessments can still be substantial.
• Family/home support: This category includes clothes, shoes, bednets and economic self-sufficiency. The need for bednets will vary depending on local climate and other conditions. In many cases donated clothes and shoes are available at no cost, but reliance on donated goods may not be sustainable as programmes scale up considerably. Economic self-sufficiency refers to programmes to provide older children and/or their families with economic support such as microfinance loans, skills training, grants or seeds.
• Community support: This includes identification of vulnerable children and funding for community workers who can assess needs, organize support and provide some counselling and individual support. Many community workers will be volunteers but significant funds may still be required for training and transportation.
• Other services: We have not explicitly included costs for national-level advocacy and legislative reform. These may be needed in many countries to address specific issues such as school fees, the cost of health care or child protection. Also many important activities such as memory books, camps etc. are assumed to be covered under community support but these may require additional resources beyond the community worker training and support included here. We have included an estimate of the costs of administering support programmes including fund raising, planning, research etc. This category applies to the organizational costs of non-governmental organizations (NGOs) providing support or central administration costs for government-run programmes.