Strengthening families to support children affected by HIV and AIDS

Abstract

This paper provides an overview of the arguments for the central role of families, defined very broadly, and we emphasise the importance of efforts to strengthen families to support children affected by HIV and AIDS. We draw on work conducted in the Joint Learning Initiative on Children and AIDS's Learning Group 1: Strengthening Families, as well as published data and empirical literature to provide the rationale for family strengthening. We close with the following recommendations for strengthening families to ameliorate the effects of HIV and AIDS on children. Firstly, a developmental approach to poverty is an essential feature of responses to protect children affected by HIV and AIDS, necessary to safeguard their human capital. For this reason, access to essential services, such as health and education, as well as basic income security, must be at the heart of national strategic approaches. Secondly, we need to ensure that support garnered for children is directed to families. Unless we adopt a family oriented approach, we will not be in a position to interrupt the cycle of infection, provide treatment to all who need it and enable affected individuals to be cared for by those who love and feel responsible for them. Thirdly, income transfers, in a variety of forms, are desperately needed and positively indicated by available research. Basic economic security will relieve the worst distress experienced by families and enable them to continue to invest in the health care and education of their children. Lastly, interventions are needed to support distressed families and prevent knock-on negative outcomes through programmes such as home visiting, and protection and enhancement of children's potential through early child development efforts.

Growing up HIV-positive in Uganda: “psychological immunodeficiency”? A qualitative study

“…By strengthening the family, the child and adolescent will have a better opportunity to develop necessary psychological resilience factors and become less vulnerable. Besides a detected need of screening and treatment for mental disorders in HIV service provision [42] the preventive efforts consequently should target the strengthening of AIDS affected families: «The capacities of families to protect children and to compensate for their loss of caregivers, security, possessions and the like, is highly dependent on the social context, most especially, pervasive and enduring poverty and labour migration [43]. Consequently, an effective response to the challenge is to work for a basic income security as well as access to health and education services for AIDS affected families.…”

Intergenerational care for and by children: Examining reciprocity through focus group interviews with older adults in rural Uganda

“…In sub-Saharan Africa beyond the health sector, there are few formal systems of care; instead, families provide care to children, the sick, and the aged (Apt 2012;Freeman and Nkomo 2006;Mathambo and Gibbs 2009;Oppong 2006;Richter et al 2009). …”

Rethinking the family in the context of care for adolescents living with HIV in Swaziland

“…Some adults skilfully navigate these institutions not always in the best interest of the child, thereby creating obstacles for adolescents rather than supporting them in their quest for care. In the final instance adolescents living with HIV depend on their biological families for material and medical support but also for psychological care (Richter et al, 2009). However, what is conceptualised as an adolescent's family in policies, programmes, standards and guidelines should be based not only on the factual care arrangements that adolescents find themselves in, nor on legal definitions of rights and responsibilities, but also on adolescents' perceptions, hopes and desire to belong.…”

“…As elsewhere in Africa, there is little social security in Swaziland, and members of the extended family often took over caring for family members living with HIV/AIDS and orphans (cf. Abebe & Aase, 2007;Chirwa, 2002;Mathambo & Gibbs, 2009;Richter et al, 2009). Due to the high mortality rates, even relatively wealthy families saw their resources depleted, due to usually prolonged illness with AIDS (Chirwa, 2002;Kaleeba & Sunanda, 2004;Mathambo & Gibbs, 2009).…”