What Works for Women and Girls

care and services were provided, which greatly helped in overcoming the problem ofinability of ART-eligible people to access routine health services due to poverty or poortransportation (Mermin et al., 2008). (Gray III) (treatment, mortality, orphans, Uganda)The Joint Learning Initiative on Children and HIV/AIDS compiled over 50 systematicreviews by working groups of world OVC experts and found that “family-centred treatmentprogrammes may accelerate the expansion of paediatric treatment, improve children’sadherence to therapy, and secure better outcomes for children living with HIV,”(Irwin et al., 2009: 21). JLICA cited a 2007 cohort study of 151 children in South Africawho were started on HAART, which determined that 89% of children had an adherenceto treatment of greater than 95%, leading to 84% virologic suppression after 6months and 80.3% suppression after a year. The study found that having at least oneHIV-positive parent decreased the children’s chances of death, leading to the conclusionthat treating parents and keeping families infected with HIV together can improve HIVoutcomes (Reddi et al., 2008). (Gray III) (orphans, treatment, South Africa)A Joint Learning Initiative on Children and HIV/AIDS executed a systematic reviewof the impact of adult use of antiretroviral treatment on family well-being. The studyevaluated primary research and modeling studies and found that “having parents onART reduces the likelihood of children’s labour supply; increases children’s schoolattendance and improves their nutritional intake,” (Kimou et al., 2008: 9). Among 41other studies, JLICA cited a 2004–2005 longitudinal household survey of 775 randomlychosen households, households with at least one known HIV-positive adult on ARV,and households with a known HIV-positive adult not receiving ARV in 100 villagesin rural Western Kenya. The study evaluated 482 children living in these householdsand determined that after treating adults with antiretroviral therapy for six months,the number of hours that the children in the household attend school increased by 20percent overall, and 30 percent for boys. After six months of adult ART, the averagehours a week worked by boys in the labor supply decreased by 7.46 hours. Lastly, ARVtreatment of parents was found to improve the nourishment of young children (Zivin etal., 2006). (Gray III) (orphans, child labor, education, treatment, Kenya)2. Programs that promote the strength of families and offer family-centered integratedeconomic, health and social support result in improved health and education outcomes fororphans.A study done in India (year not given) with 312 HIV-positive children (including thoseon HAART) and 2,278 HIV-affected children (including those not on ART) showed thatafter providing free clinical care (including ART), nutritional supplements and community-basedsupport to HIV-positive children for 12 months, pediatric quality of life scoreamong HIV-positive and affected children improved significantly in all domains—physical,social, emotional and educational, with no differences by sex. The program alsoresulted in a significant increase in the proportion of HIV-affected children aware ofWHAT WORKS FOR WOMEN AND GIRLS359