Highly Vulnerable Children Research Center
Community-based care and support programmes for orphaned and vulnerable children and their families are a critical component of HIV prevention and treatment efforts worldwide. The challenges of evaluating community-based programmes for HIV-affected families limit the evidence base for effective social work programming. Addressing these challenges can improve the validity of evaluations to provide better direction for the programme under study as well as promote best practices generally.
Children and adolescents affected by HIV are at elevated risk of depression, yet research on related interventions in this population is scarce in sub-Saharan Africa. This study sought to examine the effects of interpersonal psychotherapy for groups (IPTG) on depressive symptomology among orphaned and vulnerable adolescents in South Africa. A cluster randomized controlled trial wherein adolescents ages 14–17 enrolled in community-based programming for HIV-affected and vulnerable families were randomly assigned by geographic cluster to participate in a 16-session IPTG intervention or the standard of care (n = 489).
The objective of this study was to assess standard grief measures through cognitive interviews with bereaved adolescents in Free State, South Africa, and make recommendations designed to improve the measurement of grief in this and similar populations. Twenty-one parentally bereaved adolescents participated in semi-structured cognitive interviews about the Core Bereavement Items (CBI) questionnaire, Grief Cognitions Questionnaire for Children (GCQ-C), or Intrusive Griefs Thoughts Scale (IGTS).
HIV counseling and testing (HCT) is critical for children in generalized epidemic settings, but significant shortfalls in coverage persist, notably among orphans and others at disproportionate risk of infection. This study investigates the impact of a home visiting program in South Africa on orphaned and vulnerable children’s uptake of HCT. Using propensity score matching, survey data for children receiving home visits from trained community-based care workers were compared to data from children living in similar households that had not yet received home visits (n = 1324).
Evidence-based approaches are needed to address the high levels of sexual risk behavior and associated HIV infection among orphaned and vulnerable adolescents. This study recruited adolescents from a support program for HIV-affected families and randomly assigned them by cluster to receive one of the following: (1) a structured group-based behavioral health intervention; (2) interpersonal psychotherapy group sessions; (3) both interventions; or (4) no new interventions.
Cash transfer programs hold significant potential to mitigate the economic burdens resulting from the HIV epidemic and enhance the wellbeing of affected children. South Africa offers two cash transfers designed specifically to benefit children: the Child Support Grant, for low income families with children, and the Foster Child Grant, for children living outside of parental care. Given the high proportion of HIV-affected children who qualify for these grants, increasing grant access among eligible families is a natural objective for many programs targeting orphans and vulnerable children.
Home visiting is a popular component of programs for HIV-affected children in sub-Saharan Africa, but its implementation varies widely. While some home visitors are lay volunteers, other programs invest in more highly trained paraprofessional staff. This paper describes a study investigating whether additional investment in paraprofessional staffing translated into higher quality service delivery in one program context. Beneficiary children and caregivers at sites in KwaZulu-Natal, South Africa were interviewed after 2 years of program enrollment and asked to report about their experiences with home visiting.
The AIDS epidemic has created an unprecedented number of orphans. While largely absorbed by extended family, this additional responsibility can weigh heavily on their caregivers. The concept of caregiver burden captures multiple dimensions of well-being (e.g., physical, social and psychological). Measuring the extent and determinants of caregiving burden can inform the design of programmes to ease the negative consequences of caregiving. This study uses the baseline data from a study assessing interventions for orphans and vulnerable adolescents in the Eastern Cape, South Africa.
Children and families affected by HIV are at considerable risk for psychological distress. Community-based home visiting is a common mechanism for providing basic counseling and other services to HIV-affected families. While programs emphasize home visitor training and compensation as means to promote high-quality service delivery, whether these efforts result in measurable gains in beneficiaries’ well-being remains largely unanswered. This study employs a longitudinal quasi-experimental design to explore whether these kinds of investments yield concomitant gains in psychological outcomes among beneficiaries.
Child maltreatment is a serious concern in South Africa and significantly undermines the development and wellbeing of children affected by it. This study aimed to explore the types of abuse that were reported for children brought to the Sunlight Safe House; an after-hours service for abused and abandoned children based in Johannesburg. The sample consisted of 1 461 cases opened at the Sunlight Safe House between January 2006 and June 2012 and included children from birth to 18 years of age.
There is concern that orphans may be at particular risk of HIV infection due to earlier age of sexual onset and higher likelihood of sexual exploitation or abuse; however, there is limited empirical evidence examining this phenomenon. Utilizing data from 1694 Black South African youth aged 14–18, of whom 31% are classified as orphaned, this analysis explores the relationship between orphan status and sexual risk. The analysis found both male and female orphans significantly more likely to have engaged in sex as compared to non-orphans (49% vs. 39%).
Child and youth care workers (CYCWs) are a crucial and growing component of South Africa’s national response to HIV and AIDS and other problems affecting children and families. CYCWs use the community-centred Isibindi model of care to reach the most vulnerable with key services including psychosocial, health, economic and education support. Understanding how to support retention in the CYCW workforce is vital to programme quality and sustainability.
Effective strategies for HIV prevention among adolescent orphans and vulnerable children (OVC) in South Africa, particularly girls and young women, are critically needed. To date, adolescent-only educational and behavioral interventions have underpinned prevention efforts with mixed success. Addressing a broader array of adolescent risk factors may help to lower HIV prevalence in this priority population. Let’s Talk is a structured adolescent HIV prevention intervention that goes beyond standard knowledge and skills-based programming to address family dynamics and mental health.
Many children in South Africa live outside of parental care, due to orphanhood, parental labour migration, unemployment, and for other reasons. Family members and other adults thus play an important role in providing substitute care. Non-parental caregivers have been found to experience high levels of psychological distress and burden, potentially leading to poor outcomes for children. The present analysis examines whether these and other potential risk factors are associated with caregiver-perpetrated physical aggression towards adolescent girls living outside of parental care in the Free State province.
Early bereavement is common in South Africa, where almost a fifth of children have lost a parent and many more have experienced the death of another family member or friend. However, little is known about young people’s psychological responses to loss in this setting.
Almost one-fifth of children in South Africa have lost a parent; many have experienced multiple losses. Bereaved children are at increased risk for psychological health problems including maladaptive grief and depression. Despite the scale of need, evidence for effective psychological support services is limited.
Children and adolescents affected by HIV are at elevated risk for depression, yet research on related interventions in this population is scarce in sub-Saharan Africa. This study sought to examine the effects of interpersonal psychotherapy for groups (IPTG) on depressive symptomology among orphaned and vulnerable adolescents in South Africa—home to the world’s largest HIV epidemic.
Community-based care and support programmes for orphaned and vulnerable children (OVC) and their families are a critical component of HIV prevention, care and treatment efforts worldwide. Addressing the challenges that confront programme evaluators in these contexts can help promote robust evidence for effective programming.
Home visiting is a popular component of programs for HIV‐affected children in sub‐Saharan Africa. Many programs are staffed by volunteers whose training and compensation is minimal, raising questions about whether investing in paraprofessional workforce development might yield measurable gains in beneficiaries’ well‐being.
Cash transfers for low‐income families are an effective investment in children’s health and well‐being. Identifying ways to increase social grant uptake among orphans and vulnerable children and their families in South Africa is therefore a priority. Home visitors may be particularly well‐positioned to connect families with the highest grants for which they are eligible.
