This paper seeks to better understand how poor urban families caring for children are able to access help from beyond the kinship group in a setting where HIV prevalence has risen to over 40%. The fieldwork shows that livelihoods were affected by multiple shocks and families were struggling to provide education, health care, clothing and food for all children in their care. Orphan status or gender did not appear to affect children's access to education. Families turned to neighbours, churches and the work place for assistance. Neighbours varied in their response and were rarely able to give material assistance. Churches were seen solely as sources of emotional and spiritual support. Work-place relationships provided material as well as emotional support. Government and NGO assistance was limited and poorly coordinated at the beginning of the fieldwork and criteria for selection was unclear to many respondents. Some respondents felt marginalised from community structures. Using respondents' experiences when trying to access education and health care, the author illustrates the importance of the quality of relationships and partnerships at all levels (international, national and local) as well as the need for more synergy between top-down and bottom-up approaches. A much stronger coordinating role for government officials and the development of public welfare support are seen as critical to alleviate the poverty in which AIDS thrives.
Keywords: child poverty, community-based orphan care, social welfare
African Journal of AIDS Research 2006, 5(1): 27–39