Children affected by HIV are one of the most marginalized groups among children. With the support from UNICEF, undertook a situation analysis to understand the current status of health, and education of family-based HIV-infected, and HIV-affected children, and the barriers faced by the parents/guardians of these children to access mainstream services for health, education, nutrition, social and child protection services.

This situation analysis showed high levels of educational disadvantages among family-based HIV affected and HIV-infected children. As compared to HIV-affected children, the educational outcomes (gap in schooling and school drop-out rates) of HIV-infected children are worse. There is a rapid dropout from schools among CABA (Children affected by HIV/AIDS), especially after 13 years of age.

Ill-health of parents and children is a concern in these households. Illness/death of one or both parents, severe financial constraints, stigma and discrimination by the family and community put these children at a high risk of falling out of the safety net. Providing more support to HIV-infected children is essential.

There is a need to focus on skills development of older CABA and economic support to families for continuation of their education. Children with overlapping risk factors and those lagging behind in school need to be actively reached out through different avenues such as ART centers, community-based organizations, and outreach workers. Sustained efforts to sensitize schools are needed to achieve ‘zero discrimination’. The challenge of including the large number of private (unaided) schools in such initiatives needs special attention.

Early diagnosis, linkage to HIV care, and retention in HIV care is crucial. Support for travel to ART centers could go a long way in ensuring retention in care. Paediatric counselling services could be strengthened through collaborations with civil society organizations.

There is a need to use all available avenues to disseminate information about social benefit schemes to increase awareness. This information needs to be presented in an easy-to-understand format.

An important observation emanating from this situation analysis is that the efforts to improve health, education and well-being of these children cannot be done in isolation of each other. Apart from providing health care, HIV programs in the country need to strengthen their coordination with non-health services such as education, social welfare and child protection services. Pro-active steps by all the concerned departments and combined efforts by government and non-government agencies working for the cause would play a crucial role in reducing the vulnerability and ensuring wellbeing of these children.