9 research outputs found
“Without a mother”: caregivers and community members’ views about the impacts of maternal mortality on families in KwaZulu-Natal, South Africa.
BACKGROUND: Maternal mortality in South Africa is high and a cause for concern especially because the bulk of deaths from maternal causes are preventable. One of the proposed reasons for persistently high maternal mortality is HIV which causes death both indirectly and directly. While there is some evidence for the impact of maternal death on children and families in South Africa, few studies have explored the impacts of maternal mortality on the well-being of the surviving infants, older children and family. This study provides qualitative insight into the consequences of maternal mortality for child and family well-being throughout the life-course.
METHODS: This qualitative study was conducted in rural and peri-urban communities in Vulindlela, KwaZulu-Natal. The sample included 22 families directly affected by maternal mortality, 15 community stakeholders and 7 community focus group discussions. These provided unique and diverse perspectives about the causes, experiences and impacts of maternal mortality.
RESULTS AND DISCUSSION: Children left behind were primarily cared for by female family members, even where a father was alive and involved. The financial burden for care and children’s basic needs were largely met through government grants (direct and indirectly targeted at children) and/or through an obligation for the father or his family to assist. The repercussions of losing a mother were felt more by older children for whom it was harder for caregivers to provide educational supervision and emotional or psychological support. Respondents expressed concerns about adolescent’s educational attainment, general behaviour and particularly girl’s sexual risk.
CONCLUSION: These results illuminate the high costs to surviving children and their families of failing to reduce maternal mortality in South Africa. Ensuring social protection and community support is important for remaining children and families. Additional qualitative evidence is needed to explore differential effects for children by gender and to guide future research and inform policies and programs aimed at supporting maternal orphans and other vulnerable children throughout their development.Web of Scienc
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The art of safe sex
A small study exploring perceptions of risk, safe sex and the severity of HIV and AIDS showed that people on antiretroviral therapy (ART ) were less careful in practising safe sex. The study showed a need to communicate appropriate HIV-prevention messages to those on treatment, says study leader, VUYISWA MATHAMBO.
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We are volunteering: communities' responses to children in need
How communities respond to families and communities affected by HIV and AIDS plays a critical role in averting destitution and crises to cushion children from the worst impacts of the epidemic. However, community initiatives face a number of challenges too.
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"We are volunteering": endogenous community-based responses to the needs of children made vulnerable by HIV and AIDS
Commissioned by Children in Distress Network (CINDI) and Irish AID, Jul
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Extended family childcare arrangements in a context of AIDS: collapse or adaptation?
Families are subjected to a number of social, economic, political and demographic challenges. In recent years, the AIDS epidemic has constituted a major challenge for already poor families due to its wide reaching social, economic and health consequences. The devastating consequence of HIV and AIDS is being seen through the prolonged illness and death of family members of prime working age which impacts on family livelihoods and the ability to provide for and protect its members. This paper forms part of a review commissioned by the Joint Learning Initiative on Children and HIV/AIDS of qualitative studies of how families in southern Africa have changed, and are changing, as a result of the impact of HIV and AIDS. This paper presents results of how
extended family childcare arrangements are changing as a result of the AIDS epidemic. In a southern African context, family denotes a wider array of relations than biological parents and their children with children growing up amongst a multitude of relations sharing responsibility for their care and upbringing (Chirwa, 2002; Verhoef, 2005). Recently, there has been growing interest in the capacity of the extended family to care for the increasing number of children whose parents have died. However, literature on the role of the extended family in caring for orphaned children remains contradictory. One approach the social rupture thesis (Chirwa, 2002) suggests that the extended family network is collapsing under the strain of AIDS. On the other hand, families are portrayed as resilient and dynamic entities which are adapting their systems of childcare in response to the epidemic (Kuo, 2007). In line with Abebe and Aase (2007) and Adams, Cekan, and Sauerborn (1998), this paper proposes a continuum of survival rather than a polarisation of extended family childcare arrangements.
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Government-funded programmes and services for vulnerable children in South Africa
This review of government funded programmes for vulnerable children was undertaken as part of a five year study to understand
how factors at the household, community, and policy levels interact to affect the wellbeing of children living in conditions jointly burdened by HIV/AIDS and poverty. One of the questions it asks is what affects whether and how families utilise services.
The review outlines policies and provisions for vulnerable children and families by all relevant government departments health, education, housing, social development, safety and security, justice and others. For the first time in one place, it sets out the legal
and policy framework ensuring the provision of services for vulnerable children, a service map for each department, delivery mechanisms and service providers. This is an invaluable resource for everyone working to improve the health and wellbeing of children and families through the fulfilment of those human rights guaranteed by the Constitution of South Africa. The review was done by Patricia Martin of Advocacy Aid and former Director of the Alliance for Children's Entitlement to Social Security (ACESS). A lawyer by training, Pat is an expert on the socio-economic policies and laws affecting children. The study, called SIZE, The Wellbeing of South African Children, is being undertaken by a team of researchers from the Human Sciences Research Council in South Africa and New York University in the United States, in collaboration with colleagues from research, government and civil society, both local and international. Funding for the study has been provided by the National Institute of Child Health and Development, the Rockefeller Brothers Fund and the University of California at Los Angeles.
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Strengthening families to support children affected by HIV and AIDS
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 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.
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A systematic review on the meaning of the concept 'AIDS orphan': confusion over definitions and implications for care
Global publications on the international AIDS epidemic report on the existence of an ever-increasing number of orphans and vulnerable children. It has been suggested that by the end of this decade there will be in excess of 25 million AIDS orphans globally, an issue which will require understanding and organisation of long-term medical, psychological and social support. This study provides a systematic review to examine the use, overuse and misuse of the term orphan and explores the benefits and limitations of this approach. It then summarises the knowledge on orphans to date. Using a search strategy of published studies and recent conference abstracts, 383 papers were identified where the concept of AIDS and Orphan was raised. The papers were systematically coded and reviewed to understand when and how a child is labelled an orphan, and to summarise the effect of
orphanhood on outcome measures, most notably psychologically and physically. All controlled studies published prior to 2006 were reviewed. A consistent picture of negative effects of parental death (however defined) on a wide range of physical, socioeconomic and psychological outcomes were recorded. Seventeen studies met criteria for in-depth review (empirical, fully published, control group). The majority of studies are cross-sectional (two are longitudinal) and employ a very wide array of measures both standardised and study specific. This detailed analysis shows a mixed picture on outcome. Although most studies report some negative effects, there are often no differences and some evidence of protective effects from quality of subsequent care and economic assistance. The lack of consistent measures and the blurring of definitions are stumbling blocks in this area.