Guest Articles

May 2

Jessie Tientcheu

Surviving a Pandemic: How ‘Economic Training’ Helps Families Live Beyond HIV/AIDS

The HIV/AIDS pandemic in Africa is no longer front-page news, but it persists.

For Aisha Nanyonga, the pandemic means opening her home to children orphaned by AIDS. She now cares for 15 such children.

Aisha is not alone. In the Wakiso district of central Uganda where she lives, orphans account for 17 percent of the population – the majority lost one or both parents to AIDS. Most AIDS orphans are taken in by extended family members. Although this is usually the child’s best option, it is not an easy one. Many families like Aisha’s are already struggling under the strain of poverty and are ill-equipped to take on the needs of additional children.

Now, a new approach seeks to ease this burden by integrating economic strengthening activities into programs that already serve orphans and vulnerable children and their extended families. It involves training practitioners with new skill sets, so they in turn can help people like Aisha develop financial independence and resilience. Even basic skills in financial management, like routine small savings, or knowing where to turn in case of illness, can make a huge difference for families struggling with limited budgets.

Spearheading this approach is the ASPIRES (Accelerating Strategies for Practical Innovation and Research in Economic Strengthening) project, supported by the United States Agency for International Development (USAID), through the U.S. President’s Emergency Plan for AIDS Relief, and led by FHI 360. ASPIRES focuses on improving the economic security of highly vulnerable individual families and children by building the capacity of local organizations through gender-sensitive programming, research and learning.

Under ASPIRES, Freedom from Hunger – now part of Grameen Foundation – has developed economic strengthening curricula and trained more than 150 practitioners from 11 countries since 2014. By integrating economic strengthening interventions into their portfolios, organizations deepen and strengthen the support provided to millions of households that now struggle to support children affected by HIV/AIDS.

During the 35-year global pandemic, roughly 17 million children lost one or both parents to AIDS – 90 percent of them in sub-Saharan Africa. Millions more live with parents or other caregivers who are HIV-positive. In addition, 3.4 million children under the age of 15 are living with HIV, the majority of whom were infected at birth by their mothers. But large, extended families depending on only one or two income earners can rapidly deplete household assets. Some caregivers are HIV-positive themselves, putting income-earning activities at risk. This ultimately undermines the economic stability of vulnerable children and their families, and increases the likelihood that children themselves will contract HIV.

Research shows that “household wealth is the single most important correlate of better (child) outcomes.” Helping the heads of these households accumulate and retain wealth is therefore paramount to building their resilience and creating better outcomes for the children in their care.

For example, a local nonprofit called the Friends of Canon Gideon Foundation enrolled Aisha in a USAID/Uganda Private Support Program that provided school supplies, psychosocial support and nutrition training. She also received business training and access to a revolving fund that supports start-up businesses. With these new skills, she started several businesses to support the 15 children in her care, including selling snacks at schools and selling water to her neighbors.

Aisha’s experience with the Private Support Program demonstrates the value of economic strengthening services that specifically target vulnerable and at-risk families. These interventions require more than traditional approaches, such as microfinance and workforce training, because of the added complications of HIV/AIDS and the social isolation that orphans and extended families often experience.

Under our work with ASPIRES, Grameen Foundation supports practitioners to design programs that build household resilience through three training courses offered at no cost to the participants:

  • Economic Strengthening for Vulnerable Children
  • Savings Groups: Designing for Impact
  • Graduation Approach: Putting Together the Pieces

The training courses help participants examine their unique context and analyze programming alternatives that can better serve the needs of the families and children. Many participants come to us after trying to implement household economic strengthening projects with limited success; others are looking for new ways to support households.

Drawing on our expertise in adult education and learner-centered design, the courses cover topics such as matching interventions to the specific economic vulnerabilities of target groups, using savings groups to increase the impact of programming, and designing programs that lead to reduced vulnerability among households.

The Savings Groups: Designing for Impact course, in particular, equips participants to design programs using best practices to link savings groups to additional services for vulnerable populations, and to ensure programs are sustainable. For example, some participants may focus on better ways to integrate psychosocial support with savings groups. Others may evaluate ways to help them scale their programming to more households. Still others may explore linkages and networking for improving access to health services.

Six-month evaluations with some participants have shown that all had made changes to their activities and interventions.

The challenges facing households like those led by Aisha are complex, and households are vulnerable on many fronts. A single shock – job loss, death of a spouse or illness – can cause a rapid downward spiral. But the right skills, knowledge, and a network of support can make it easier to cope. Using more nuanced programming, organizations can build the resilience of caregivers like Aisha and enable the children in their care to break the cycle of vulnerability and HIV transmission and lead healthy, vibrant lives.


Jessie Tientcheu is the senior director of programs at Grameen Foundation.

Photo: Aisha Nanyonga, above, left, cares for 15 children orphaned by AIDS. Organizations that work with families affected by HIV/AIDS must be ready to provide more than the traditional economic support programs to help them succeed. Courtesy of Friends of Canon Gideon Foundation




Health Care
graduation approach, savings, skill development