Peer Reviewed Publications – Page 2 – Highly Vulnerable Children Research Center

2014

Home visiting programs for HIV-affected families: a comparison of service quality between volunteer-driven and paraprofessional models

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.

2014

Caregiver burden among adults caring for orphaned children in rural South Africa

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.

2014

Does investment in home visitors lead to better psychological health for HIV-affected families? Results from a quasi-experimental evaluation in 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.

2013

Our children in crisis: An analysis of cases at the Sunlight Safe House in Gauteng

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.

2012

Caring for the caregiver: Evaluation of support groups for guardians of orphans and vulnerable children in Kenya

HIV and AIDS have altered the context in which millions of children in sub-Saharan Africa are raised. Many are under the care of a widowed or ill parent, and others are residing with their extended family. Caregivers of orphans and other vulnerable children (OVC) face a variety of stressors that may adversely affect children. This study explores potential benefits of caregivers’ membership in support groups on their own psychosocial well-being, and on the treatment and psychosocial well-being of OVC aged 8–14 under their care.

2012

Saving Lives for a Lifetime: Supporting Orphans and Vulnerable Children Impacted by HIV/AIDS

President’s Emergency Plan for AIDS Relief (PEPFAR’s) response to the millions of children impacted by HIV/AIDS was to designate 10% of its budget to securing their futures, making it the leading supporter of programs reaching orphan and vulnerable children (OVC) programs globally. This article describes the evolution of PEPFAR’s OVC response based on programmatic lessons learned and an ever growing understanding of the impacts of HIV/AIDS. In launching this international emergency effort and transitioning it toward sustainable local systems, PEPFAR helped establish both the technical content and the central importance of care and support for OVC as a necessary complement to biomedical efforts to end the HIV/AIDS epidemic.

2010

Evaluation of a case management program for HIV clients in Rwanda.

Case management is a standard practice in the United States for the effective care of people living with HIV and AIDS (PLHA); however, application of this approach in developing countries has not been demonstrated. Although great advances have been made in Africa to increase PLHA’s access to HIV services, care and support systems often remain fragmented. In September 2004, CARE International initiated a case management program in health facilities in Rwanda designed to enhance linkages between clinical and non-clinical services for PLHA.

2010

Respondent-driven sampling: A new method for studying street children with finds from Albania

Sampling methods to study street children often rely on convenience approaches. Respondent-driven sampling (RDS) is a relatively new methodology for sampling hard-to-reach populations utilizing peer-driven recruitment. It includes both field and analytical procedures to account for non-random recruitment patterns and generates statistically valid samples. This article describes RDS and assesses its effectiveness to recruit a diverse sample of street children, defined as children aged 10–17 years who engage in economic activity on the street in Tirana, Albania.

2009

Impact of a mentoring program on psychosocial wellbeing of youth in Rwanda: Results of a quasi-experimental study

Addressing the psychosocial needs of vulnerable children and youth is viewed increasingly as a priority of humanitarian programs, particularly in Africa, where the scale of the problem necessitates community-based solutions. This quasi-experimental study tested a model of adult mentorship and support to improve psychosocial outcomes among youth-headed households in a rural area of Rwanda. Two rounds of data were collected from youth who served as heads of their households.

2009

Depressive symptoms among youth heads-of-household in Rwanda: Correlates and implications for intervention

Objective To examine the level of depressive symptoms and their predictors in youth from one region of Rwanda who function as heads of household (ie, those responsible for caring for other children) and care for younger orphans.

2008

Barriers to the community support of orphans and vulnerable youth in Rwanda

A consistent theme in the literature on interventions for orphans and vulnerable children is the need for community-based care. However, a number of socio-cultural factors may impede community response. In this study, mixed methods are used to elucidate community-level barriers to care for orphans and vulnerable youth in Rwanda. Data from a large survey of youth heads of household on perceptions of marginalization from the community and the factors predicting that marginalization are considered in light of additional data from a survey of adults who volunteered to mentor these youth and focus groups with both community adults and youth heads of household.

2006

Sexual Risk Behavior among South African Adolescents: Is Orphan Status a Factor?

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%).