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Titlean exploration of the delivery of community-based psychosocial support services to children living
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Table of Contents
                            COVER PAGES Memory Munyaradzi Jan 2015-Final
	DECLARATION
	DEDICATION
	ACKNOWLEDGEMENTS
	SUMMARY
	TABLE OF CONTENTS
		LIST OF TABLES
		LIST OF ACRONYMS
declaration3
Memory Zulu Munyaradzi  2015 Corrected Final Dissertation Jan 2015doc 1
	LITERATURE REVIEW
		2.1 INTRODUCTION
			2.2 EXTENT OF THE HIV AND AIDS PANDEMIC AMONG CHILDREN
		Table 1: Comparison of global statistic of children living with HIV and AIDS: 2008 and 2011
			2.2.2 Zimbabwean perspective
		Table 2: Zimbabwean HIV and AIDS National HIV Estimates 2011
		2.3 THE NEED FOR PSYCHOSOCIAL SERVICES FOR CLHA
			2.4.1 Treatment adherence
			2.4.2 HIV status disclosure
			2.4.3 Emotional challenges
			2.4.4 Psychiatric challenges
		2.5 DIFFERENCES IN MANAGING HIV IN CHILDREN AND ADULTS
			2.6.3 Provision of PSS through palliative services for children
			2.7.2.1 Examples of existing PSS initiatives for CLHA in Africa
			2.8.1.1 Social support
				2.8.1.2 Social support and the buffering hypothesis
				2.8.1.3 Social support and HIV and AIDS
		2.9 CONCLUSION
	DATA ANALYSIS AND INTERPRETATION
		4.1 INTRODUCTION
		4.2 DEMOGRAPHIC CHARACTERISTICS OF THE RESEARCH
		PARTICIPANTS
		4.3 SIMBARASHE NATIONAL NETWORK OF PEOPLE LIVING WITH HIV AND AIDS
			4.4.1 Identification of children in need of PSS
			4.4.2 Voluntary Counselling and Testing of children
			4.4.3 Disclosure of the child’s HIV status
			4.4.4 Support groups
			4.4.5 Case management
			The content analysis notes established that the following published resources found on the CBO library were used as reference material for the case management:
			4.4.6 Transitory school for OVCs
			4.4.7 Child-friendly rights-based approach
		4.5 CRITICAL FACTORS INFLUENCING DELIVERY OF PSS
			4.5.1 Psychosocial challenges experienced by CLHA
			4.5.1.1 Recognition that CLHA have PSS needs
				4.5.1.1.1 Drug adherence
				4.5.1.1.3 Disclosure
				4.5.1.1.4 Isolation and or depression
				4.5.1.1.5 Bereavement
				4.5.1.1.6 Stigmatisation and discrimination
				4.5.1.1.7 Poverty
				4.5.1.1.8 Stress
				4.5.2.1.1 Children’s rights
		4.5.3 Community-based approach
			4.5.3.1.1 Committed community-based volunteers
		4.5.4 Caregivers’ attitudes
		4.5.6 Partnerships
		4.6 MEETING THE PSS NEEDS OF CLHA
		4.7 REFERRAL LINKAGES
		4.8 IMPROVING COMMUNITY-BASED PSS DELIVERY TO CLHA
		AfriCASO. Global fund pulls life support plug.2012. Available at: 5TUhttp://www.africaso.net/index.php?option=com_content&view=article&id=680%3Azimbabwe-global-fund-pulls-life-support-plug&catid=39%3Aarchived-news&Itemid=7(U5Tlast accessed 31/12/2012).
	Personal background
	Organisation background
	Improvement of community-based PSS delivery for CLHA in the district
	Discussion points for the focus group discussions with project staff of the CBO
annexure B
annexure G
                        
Document Text Contents
Page 1

AN EXPLORATION OF THE DELIVERY OF COMMUNITY-BASED PSYCHOSOCIAL

SUPPORT SERVICES TO CHILDREN LIVING WITH HIV AND AIDS BY THE SIMBARASHE

NATIONAL NETWORK FOR PEOPLE LIVING WITH HIV AND AIDS IN THE KADOMA DISTRICT,

ZIMBABWE











by



MEMORYMUNYARADZI







submitted in accordance with the requirements

for the degree of



MASTER OF ARTS IN SOCIAL BEHAVIOUR STUDIES IN HIV/AIDS













at the





UNIVERSITY OF SOUTH AFRICA



SUPERVISOR: MS S E KOEN





FEBRUARY 2014

Page 2

ii


DECLARATION



I, declare that AN EXPLORATION OF THE DELIVERY OF COMMUNITY-BASED

PSYCHOSOCIAL SUPPORT SERVICES TO CHILDREN LIVING WITH HIV AND AIDS

BY THE SIMBARASHE NATIONAL NETWORK F OR PEOPLE LIVING WITH HIV AND

AIDSIN THE KADOMA DISTRICT, ZIMBABWE is my own work, and that all the sources

that I have used or quoted have been indicated and acknowledged by means of

complete references.



Name:

Student number:





_______________________ ____________________

SIGNATURE DATE

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As noted above, caregivers of the children who were tested to be living with HIV,

are constantly encouraged by the CBO’s project personnel to allow their children

to join the children’s support groups offered by the Simbarashe Network for

People Living with HIV and AIDS. The CBO conducts weekly support group

meetings, held every Saturday, for the children. Responses on what PSS was

giving to CLHA from senior project personnel Paida and Abel, field officer Petros,

as well as the caregivers of CLHA were as follows:



Paida: “We do support group every Saturday.”



Abel: As an organisation [Simbarashe National Network for People Living

with HIV and AIDS] we do support group meetings and under those

platforms we engage the children in playing the games ...”



Betty: “There are support groups, they play together, they act dramas,

they are being taught how things are like and how to cope when you are

on ART. They are being taught everything that we do together, playing ball

with others, doing this together as one.”



Petros: “... here at Simbarashe there are support groups, we had not

talked about it, those support groups ... every Friday or every Saturday

they meet here, dealing with different kinds of children with different

problems, so we touch so many issues.”



Caregivers of CLHA [answering all at once]: “They [CLHA] come once a

week to support groups ...”



The organisation offers this service both to CLHA and to those who are not living

with HIV, mainly because they want to reach out to all vulnerable children in the

community and in addition want to reduce stigmatisation and discrimination. The

Page 130

114


CBO founder explained that, after the VCT for children had been conducted, he

realised the need for the formation of support groups for the CLHA, which later

integrated children living without HIV and AIDS. Recalling a statement he made

to community members on setting up support groups for children, he stated:



Robert: “... let them [referring to children who had undergone VCT and

were found to be living with HIV] then start PSS programmes. ‘How then?’

Let’s formulate support groups for these children,’ and we immediately

formulated support groups, 6 support groups. Then we discovered that we

were isolating the children now to say those living with HIV only, because

we then create a stigma. So then we then said support groups will involve

those living with and those without HIV. So every Saturday now children

will group for a sporting activity … which we would call “kicking out HIV

through sport”. Then we could play sports with them and would then sit

down with them again for a session of drug adherence now that they are

on treatment ...”



Although the meetings cater for both children living with HIV and AIDS and those

without, the CBO project personnel noted that the support group sessions

covered various topics, such as HIV treatment and drug adherence, healthy

eating, sexual abuse, children’s rights, HIV prevention, and stigmatisation and

discrimination, specifically assisting CLHA and at the same time empowering

those not infected with knowledge and information. The case management

system in place at the CBO then further helped to target those children

specifically living with HIV and AIDS. The founder of the CBO, Robert, was asked

whether children living without HIV had ever asked why they were being taught

topics such as drug adherence when it did not affect them. Robert explained:



Robert: “They haven’t, because when it’s being taught it’s not targeted. It’s

like being taught as a subject, something you have to know. Then there is

the case management issue of targeting those who are actually on

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