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Children affected by HIV/AIDS in Southern Africa

Rebuilding Confidence- Developing a psychosocial support programme for children affected by HIV/AIDS in Southern Africa

Duration:	November 2006 - April 2012
Status:	completed
Region:	Southern Africa

The number of children and youth affected by HIV/AIDS in rural Sub-Saharan Africa is alarmingly high. The impacts of AIDS transcend the bio-medical realm and have deleterious impacts on the psycho-social wellbeing as well. This research project subjected various interventions that target children affected by HIV/AIDS (CABA) in Southern Africa to scientific study. The aim is to identify essential factors that make an intervention successful, in order to develop an effective “best practice” approach that meets the psychosocial needs of the affected children. The results show that not only orphans suffer from lower wellbeing and an increased risk for mental health problems, but also children living with chronically ill caregivers. Programming focus on vulnerability should be broadened to include not just orphans, but other at-risk groups as well. The study revealed that appropriate measures such as improving care at home, social support, and relations with peers as well as reducing daily stress, hunger and physical health problems, can greatly improve psychological wellbeing. Social factors exert a greater influence than material factors to reduce child depression. A mere poverty alleviation programme is thus not suitable to fight the severe social and psychological difficulties of the target group. For more results please see the policy briefs available below for download.

According to estimates by UNAIDS, 14 million children and youth in sub-Saharan Africa have lost their parents to AIDS in recent years. In certain rural areas up to a third of all minors are orphaned. Many others are affected by the illness of their parents where the care-giving role has been reversed. For CABA, the illness and loss of their parents are frequently associated with material hardship, socio-economic decline and social stigma and, in the worst case, psychological trauma can result. CABA are also more vulnerable to abuse and they face a greater risk of HIV infection themselves. The high numbers of CABA carry far-reaching social consequences for the countries involved and potentially pose a threat to their political stability.

In light of this situation, a number of intervention programmes have been initiated, but their effectiveness has rarely been studied scientifically. This research project seeks to identify the essential elements of a successful programme, focusing especially on the wellbeing and coping capacities of the children. In collaboration with REPSSI, the results are to be fed back to the examined programmes and made available to other interested organisations.

Research objectives

Identification of particular risk factors of CABA, compared to other children
Examination of the effectiveness of various psychosocial interventions to support CABA and other vulnerable children
Creating an evidence base for the development of a sustainable and cost-effective approach to improve the psychosocial wellbeing and coping of CABA and other vulnerable children
Knowledge transfer in collaboration with REPSSI
Capacity-building of the local research team and the implementing partner

Target group(s)

REPSSI and child protection organisations at the grassroots level, indirectly also CAB

Project description (pdf, 69 KB)

Funding Partners

Novartis Foundation for Sustainable Development (NFSD)

Swiss Agency for Development and Cooperation (SDC)

Implementing Partners

REPSSI

ChildFund Zambia

Documents

Research Report Phase I (pd 1,8MB)

Links

Photo Gallery

Contact

Adrian Gschwend
Project Manager
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+41 (0)32 344 30 51

Interventions
The research project took place in five communities with more than a hundred villages and settlements. In one of these communities, a control group was formed, where the interventions started only after the research activities have been concluded (“wait-list group“). In the other communities, a measure to improve the material livelihood was implemented with the participating households: By means of poultry rearing and the production of sunflower oil, income is being generated, from which households with vulnerable children pay daily necessities and school books, school uniforms and school fees. Alongside, several different interventions were conducted directly with children and youth: In so called Children’s Committees , sensible and healthy leisure activities like sport, play, dance and other cultural activities, were offered to as many children as possible. Furthermore, this participatory child-led organisation represented the interests of the children and youth in the communities. Its members determine the activities in order to learn to take responsibility and control over their own lives. Together, they attempt to face challenges like the prevention of sexually transmitted diseases and to foster the protection of children’s rights. In addition, parts of these children participate in specific psychosocial interventions developed by REPSSI: Hero Book and Tree of Life use narrative and creative techniques to help children cope with their living conditions. They are designed to strengthen their self esteem and to promote social interaction with peers. The tools are very structured and may help to integrate elements of psychosocial support in established activities.

Research plan and methods
A quasi–experimental research design was used, in which different groups of children participated in different single or combined interventions. In order to adequately assess the effect of an intervention, the psychosocial wellbeing and coping of the participants was measured prior to and after the introduction of an intervention and in comparison with a control group. In the first research phase (Nov 2006 – Aug 2009) a qualitative pre-study as well as three quantitative data collections has been accomplished using standardised interviews. In a second phase (Sep 2009 - Dec 2010) two further data collections were carried out, in order to enhance the findings. In a third phase (Jan – Jun 2011) the findings were analysed, disseminated and fed back to the partner organisations, funding partners, governmental agencies, research community and other stakeholders. For this research project SAD received valuable input from an expert committee consisting of researchers and development practitioners from Switzerland and Southern Africa. The data collection was implemented by a local research team under guidance of SAD.

Recommendations

The results are available in a series of policy briefs:

Policy Brief 1 Risks associated with Vulnerability (pdf 203KB)

Policy Brief 2 Prevalence of Mental Health Problems (pdf 140KB)

Policy Brief 3 Psychosocial Interventions (pdf 193KB)

Policy Brief 4 Poverty Alleviation (pdf 178KB)

Policy Brief 5 Intervention Exposure (pdf 230KB)

Policy Brief 6 Main predictors of youth depression (pdf 230KB)

Policy Brief 7 Factors mediating depression for vulnerable youths (pdf 240KB)

Policy Brief 8 School drop out (pdf 151KB)

Policy Brief 9 Parental Separation (pdf 162KB)

Policy Brief 10 Complicated Grief (pdf 152KB)