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 immunodeficiencyvirus (hiv) pandemic. new life home (nlh) specialises in the care of infants who have been orphaned or abandoned, oftenbecause of their exposure to hiv and places them for adoption . this paper documents the lessons learnt from the home's first 8.5years of existence. methods: this is retrospective study an alyses the pattern of the 490 infants admitted at nlh. the characteristics ofthe infants'stay are analysed : bio -data, weight, hiv exposure, referring organisation/agent and outco me. this study ceased to followinfants after adoption, death, transferral to other homes, or reunion with own family. the infants came via health facilities (58%), localauthorities (15%), good sama ritans (2% ) , and other children's homes (25 %) . results: at the end of the study period, 425 (92%) of babieswere 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 of77.6/1000 was demonstrated with the key associated factors being hlv exposure (p <0001), and weight at admission (p=0.002). themortality 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 osenot 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 waspneumonia (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 biologicalfamilies 31(6.3%) and a minority 7(1.4%) transferred to other children's homes which cater for older children. conclusion: nlhdemon strates a possible model of care for ovc as majority of vulnerable child can have the opportunity to be adopted and therebya 'second lease' of life. this strategy is worth studying and duplicating in the mitigation of the ovc dilemma in hiv high prevalencecountries in sub-saharan africa.