From HIV Abandonment to Adoption Case study of NewLife Home for abandoned babies, Kenya

Objective: The number of orphaned and vulnerable children (OVC) worldwide has increased as a result of the Human Immunodeficiency Virus (HIV) pandemic. New Life Home (NLH) specialises in the care of infants who have been orphaned or abandoned, often because of their exposure to HIV and places them for adoption . This paper documents the lessons learnt from the Home s first 8.5 years of existence. Methods: this is retrospective study an alyses the pattern of the 490 infants admitted at NLH. The characteristics of the infants stay are analysed : bio -data, weight, HIV exposure, referring organisation/agent and outco me. This study ceased to follow infants after adoption, death, transferral to other homes, or reunion with own family. The infants came via health facilities (58%), local authorities (15%), good Sama ritans (2% ) , and other children s homes (25 %) . Results: At the end of the study period, 425 (92%) of babies were still alive. Of those who died, 8% were less than 6 months old (P 0 .003) and 45% were HIV positive. A child mortality rate of 77.6/1000 was demonstrated with the key associated factors being HlV exposure (p 0001), and weight at admission (P=0.002). The mortality rate for the HIV exposed was 71/1000 at 6 months, 94.7/1000 at 12 months and 100.6 /1000 at 18 months, while for th ose not exposed to the virus it was 43.3/1000 at 6 months and 46.7/ 1000 at 12 months. The major cause of de ath in th e HIV exposed was pneumonia (56%) and septi caemi a (22%) . The majority of infant s, 3 23 (67%) wer e ado pted, som e were re abso rbe d into their biological families 31(6.3%) and a minority 7(1.4%) transferred to other children s homes which cater for older children. Conclusion: NLH demon strates a possible model of care for OVC as majority of vulnerable child can have the opportunity to be adopted and thereby a second lease of life. This strategy is worth studying and duplicating in the mitigation of the OVC dilemma in HIV high prevalence countries in sub-Saharan Africa.