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Tackling the crisis of orphaned children

Large group of child and youth care workers with visitors from the United States Government

Child and youth care workers from Empilweni in Khayelitsha with members of the United States Congress, the Consul General, representatives from USAID and PEPFAR and NACOSA staff.

With the success of South Africa’s antiretroviral treatment programme – the world’s largest with an estimated four million people on treatment – the number of children orphaned by AIDS has slowly declined. But new modelling estimates that South Africa now has 150,000 children orphaned due to Covid-19. This number is jumps to over 200,000 when including children who have lost either their primary or secondary caregiver (like a grandparent).[1]

NACOSA has run programmes for vulnerable children since 2011 and implements a programme working to prevent HIV, AIDS and gender-based violence (GBV) in orphans and vulnerable children in the Western Cape, funded by PEPFAR and USAID. “Covid-19 and socio-economic pressures in communities means there are still many extremely vulnerable children who live without one or both parents, are not attending school, experience violence and neglect or are living with HIV,” explained Monene Mamabolo, the programme’s Chief of Party, at a recent visit by members of the United States Congress, accompanied by US Consul General Todd Haskell.


An estimated 3.3 million children and adolescents in South Africa have lost one or both parents to AIDS which in itself tends to make children more vulnerable to HIV, with orphan-hood increasing HIV risk two-fold. Programmes that work to reduce the risk and vulnerabilities of children and young people are therefore vital to the overall drive to end AIDS in South Africa by 2030.

Group of child and youth care workers in traditional Xhosa dress

Child and youth care workers from Empilweni

The programme deploys trained, registered and regulated child and youth care workers[2] from community organisations like Empilweni in Khayelitsha, to work with vulnerable children and their families using a comprehensive case management approach. “Child and youth care workers are recruited from the communities where the programme operates and are able to find, reach and respond to the needs of vulnerable children and their families, building supportive relationships that increase individual and family resilience,” continued Monene.

“They really hold up the sky in these communities, working with families to make sure children are healthy, safe, stable and in school.”


The biggest issues for orphaned and vulnerable children and adolescents remain poverty and food insecurity, high rates of violence and neglect, not attending school and limited access to healthcare services such as testing and treatment for HIV and TB. “We need a wrap-around, systems-strengthening approach that empowers communities and families to care for their children,” said Monene. “This approach requires investment – for which we are very grateful to USAID and PEPFAR. But it also needs all sectors of society working together in a coordinated way to reduce the vulnerability of children and young people.”

[1] Imperial College London, 2022. Global Reference Group for Children Affected by Covid-19.

[2] Child and Youthcare Workers are qualified with a minimum of a Further Education and Training regulated by the South African Council for Social Service Professions (SACSSP)