• Absence of caregiver: 90% orphaned, extended family may not be supportive.
    • Poor household care: children lack nutritional input and emotional support. Poor condition of sanitation and hygiene.
    • Neglect: sick children are often neglected due to lack of awareness and financial capacity.
    • Lack of awareness and discipline: parents are not aware of the importance of adherence to give ARV and other medication for these children.
    • Lack of education: parents are low income and mostly uneducated.
    • Limited resources: some hospitals refuse to treat; parents need to have documents to access free government services.
    • Limited types of pediatric ARV that provided by government, so that some children still have to consume adults formula