Study Title: The benefits and necessity of recreation for AIDS orphans: Through the eyes of a child

Authors: CM Schreck, CDP Meyer, JT Weilbach, MM Steyn

Abstract: Millions of South African youth have been left behind as orphans as a result of the AIDS pandemic, turning to high risk behaviour to survive. These risk behaviours have a negative effect on their quality of life. To aggravate the problem further, most of these youths do not have access to recreation programmes and activities. The benefits obtained from recreation participation play a changing role in managing at-risk youth. The purpose of the study was to determine if recreation programmes are beneficial and a necessity for specifically AIDS orphans within a South African context, as seen from the youth’ perspectives. A qualitative research design was used. The participants were students at Thanda After-School Programme (Thanda ASP) (n=8), representative of the different programme areas offered by Thanda ASP. In-depth data collection methods were employed, using individual, semi-structured interviews and document analysis. The process resulted in two key categories: the benefits of this recreation programme and the necessity of these programmes for AIDS orphans. The participants stated that the recreation programme ensured health, emotional, social and psychological benefits to them, which therefore resulted in a better quality of life. The necessity was accentuated by the risk behaviours the youth reported before participating in the programme as well as by their need to learn and develop important skills. It is evident from the research that recreation programmes can address the problems that AIDS-orphaned youth face and that the benefits stated in the literature apply to AIDS orphans at Thanda as well.

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Authors: Tapologo Maundeni, Tumani Malinga-Musamba

Date: April 2013

Abstract: With the orphan population escalating, communities continue to rely on relatives to provide care to orphans. Therefore, there is a need to explore the role of caregivers with regard to the well-being of orphans, the challenges they face, as well as how they could be empowered to be more responsive to children’s needs. The paper acknowledges that informal caregivers play an important role in the lives of orphans. The paper also concedes that, in the process, caregivers are faced with challenges which make it difficult for them to fulfil their responsibilities and roles. As a result, they sometimes act as sources of stress to orphans, which eventually complicate the children’s adjustment to the loss of their parents. Lastly, the paper paves the way to ensuring that challenges faced by informal caregivers are addressed in a manner that will make them more supportive to orphans.

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Authors: Donald Skinner, Carla Sharp, Sean Jooste, Sakhumzi Mfecane, Leickness Simbayi

Date: May 2013

Abstract:

Background: It is generally assumed that orphan status increases the risk to children of a range of negative outcomes. In South Africa, death of parents due to HIV-related illness is contributing to a rapid increase in the prevalence of orphans. This paper presents descriptive data from two South African communities, namely Kopanong, in the Free State and Kanana in the North West province, characterising the differences between orphans (double, maternal and paternal) and non-orphans on key criteria of social vulnerability.

Objectives: The objective was to obtain a better understanding of how different types of orphans and non-orphans may differ in these key areas as a crucial starting point for addressing the devastating consequences the AIDS epidemic has on these children’s lives. While the study focuses on two specific areas these will provide insight into the general situation of orphans in South Africa.

Methods: A cross-sectional census survey was conducted in the two communities of Kopanong, comprising n = 5254 households and Kanana, comprising n = 12 984 households.

Results: In Kopanong, 8.2% of children had lost both parents, 19.1% had lost their father and 6.5% their mother only, whilst in Kanana the results were 6.5%, 28.1% and 3.7% respectively. Loss of both parents appeared to have a consistent impact on material need, including access to food, clothing and essential services, whilst loss of a single parent seems to have a more variable impact. At present, there are very few child headed households, but this constitutes a risk in the longer term.

Conclusions: Orphans appear to be more vulnerable in terms of material need. Children assessed in this study as being most in need were not accessing adequately many services directed at them. There is a need to extend understanding and measurement of emotional need and abuse.

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Authors: Wathen CN, MacGregor JC, Hammerton J, Coben JH, Herrman H, Stewart DE, MacMillan HL; PreVAiL Research Network.

Date: 2012

Abstract:

Intimate partner violence (IPV) and child maltreatment (CM) are major global public health problems. The Preventing Violence Across the Lifespan (PreVAiL) Research Network, an international group of over 60 researchers and national and international knowledge-user partners in CM and IPV, sought to identify evidence-based research priorities in IPV and CM, with a focus on resilience, using a modified Delphi consensus development process.

METHODS:

Review of existing empirical evidence, PreVAiL documents and team discussion identified a starting list of 20 priorities in the following categories: resilience to violence exposure (RES), CM, and IPV, as well as priorities that cross-cut the content areas (CC), and others specific to research methodologies (RM) in violence research. PreVAiL members (N = 47) completed two online survey rounds, and one round of discussions via three teleconference calls to rate, rank and refine research priorities.

RESULTS:

Research priorities were: to examine key elements of promising or successful programmes in RES/CM/IPV to build intervention pilot work; CC: to integrate violence questions into national and international surveys, and RM: to investigate methods for collecting and collating datasets to link data and to conduct pooled, meta and sub-group analyses to identify promising interventions for particular groups.

CONCLUSIONS:

These evidence-based research priorities, developed by an international team of violence, gender and mental health researchers and knowledge-user partners, are of relevance for prevention and resilience-oriented research in the areas of IPV and CM.

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Authors: Ssewamala FM, Sperber E, Blake CA, Ilic VP.

Date: 2011

Abstract: Youth of color are disproportionately likely to grow-up in poor, disadvantaged neighborhoods characterized by high levels of psychosocial stressors and inadequate supportive resources. Poverty and racial minority status correlate with an increased risk of high-school dropout, teen pregnancy, substance abuse, and sexually transmitted infections (STIs). Given these trends, child welfare researchers are developing various interventions to increase the protective resources and social opportunities available to youth of color. This article reports results of a preliminary, qualitative study that investigated the feasibility and acceptability of an economic empowerment intervention in the South Bronx and East Harlem, New York. Using focus groups and brief questionnaires with youth and their parents/guardians (N=24 dyads), we explored attitudes toward youth educational savings accounts, financial planning classes, and mentorship for inner-city youth. Findings indicate a strong interest in an economic empowerment intervention among adolescents and their caregivers in these communities. These findings have implications for the design of larger-scale research programs that aim to improve inner-city youth’s socio-economic wellbeing using economic empowerment models.

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Authors: Boothby N, Wessells M, Williamson J, Huebner G, Canter K, Rolland EG, Kutlesic V, Bader F, Diaw L, Levine M, Malley A, Michels K, Patel S, Rasa T, Ssewamala F, Walker V.

Date: 2012

Abstract:

Children outside of family care face increased risk of threats to their well-being, have lower educational achievement, and experience adverse developmental outcomes. While it is generally accepted that early response and intervention is critical to reducing the risk of harm for children who have been separated from their families, it is not always clear what the most effective early response strategies are for assessing and addressing their immediate needs. The purpose of this review was to identify evidence-based early response strategies and interventions for improving the outcomes of children outside of family care, including children of and on the street, institutionalized children, trafficked children, children affected by conflict and disaster, and who are exploited for their labor.

METHODS:

A multi-phased, systematic evidence review was conducted on peer-reviewed and gray literature, which yielded a total of 101 documents that met the inclusion criteria and were reviewed.

RESULTS:

Overall there is a weak evidence base regarding assessment and early response interventions for children living outside of family care. Few studies included careful outcome measures or comparison groups. Although few proven interventions emerged, the review identified several promising early interventions and approaches. In emergency settings, family tracing and reunification is a highly effective response in regard to separated children, whereas placing children in institutional care is problematic, with the possible exception of time-limited placements of formerly recruited children in interim care centers. Livelihood supports are promising in regard to preventing and responding to children living outside family care. Other promising interventions include psychosocial support, including the use of traditional cleansing rituals as appropriate, educational supports such as Child Friendly Spaces, the maintenance of family connectedness for children of or on the streets, the use of community-based approaches that aid social integration, and approaches that enable meaningful child participation. A recurrent theme was that to be effective, all assessments and interventions must fit the context.

CONCLUSION:

A strong need exists for strengthening the evidence base regarding the effectiveness of early assessments and responses to children living outside family care and for using the evidence to guide operational policy and practice. Recommendations regarding policy, practices, and research emerged from the review process.

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Authors: Robertson L, Mushati P, Eaton JW, Sherr L, Makoni JC, Skovdal M, Crea T, Mavise G, Dumba L, Schumacher C, Munyati S, Nyamukapa C, Gregson S.

Date: 2012

Abstract: Census data, collected in July 2009, from 27,672 children were used to compare the effectiveness, coverage and efficacy of three household-based methods for targeting cash transfers to vulnerable children in eastern Zimbabwe: targeting the poorest households using a wealth index; targeting HIV-affected households using socio-demographic information (households caring for orphans, chronically-ill or disabled members; child-headed households); and targeting labour-constrained households using dependency ratios. All three methods failed to identify large numbers of children with poor social and educational outcomes. The wealth index approach was the most efficient at reaching children with poor outcomes whilst socio-demographic targeting reached more vulnerable children but was less efficient.

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Authors: Stack DM, Serbin LA, Girouard N, Enns LN, Bentley VM, Ledingham JE, Schwartzman AE

Date: 2012

Abstract: The present research examined how family psychosocial risk may be associated with emotional availability (EA) across age and time in two longitudinal, intergenerational studies with high-risk, disadvantaged mother-child dyads. Study 1 examined dyads during preschool and middle childhood. Study 2 examined a different sample of dyads, tested intensively at five time points (6, 12, and 18 months; preschool; and school age). Across studies, maternal childhood histories of aggression and social withdrawal predicted negative EA (higher levels of maternal hostility) during mother-child interactions at preschool age. In Study 1, mothers with higher levels of social withdrawal during childhood had preschoolers who were less appropriately responsive to and involving of their mothers during interactions. In Study 2, higher levels of observed appropriate maternal structuring predicted child responsiveness while observed maternal sensitivity (and structuring) predicted observed child involvement. More maternal social support and better home environment combined with lower stress predicted better mother-child relationship quality. Findings contribute to the burgeoning literature on EA by focusing on a high-risk community sample across time and generations. Results are interpreted in light of the developmental psychopathology framework, and have implications for a broader understanding of how EA is related to parental history and personal characteristics, as well as ongoing family and environmental context.

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Authors: McGoron L, Gleason MM, Smyke AT, Drury SS, Nelson CA 3rd, Gregas MC, Fox NA, Zeanah CH.

Date: 2012

Abstract:

Children exposed to early institutional rearing are at risk for developing psychopathology. The present investigation examines caregiving quality and the role of attachment security as they relate to symptoms of psychopathology in young children exposed to early institutionalization.

METHOD:

Participants were enrolled in the Bucharest Early Intervention Project (BEIP), a longitudinal intervention study of children abandoned and placed in institutions at or shortly after birth. Measures included observed caregiving when children were 30 months of age, observed attachment security at 42 months, and caregiver reports of children’s psychopathology at 54 months. At 54 months, some children remained in institutions, others were in foster care, others had been adopted domestically, and still others had been returned to their biological families. Thus, the children had experienced varying amounts of institutional rearing.

RESULTS:

After controlling for gender, quality of caregiving when children were 30 months old was associated with symptoms of multiple domains of psychopathology at 54 months of age. Ratings of security of attachment at 42 months mediated the associations between quality caregiving at 30 months and fewer symptoms of psychopathology at 54 months.

CONCLUSIONS:

Among deprived young children, high-quality caregiving at 30 months predicted reduced psychopathology and functional impairment at 54 months. Security of attachment mediated this relationship. Interventions for young children who have experienced deprivation may benefit from explicitly targeting caregiver-child attachment relationships.

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