Enabling households to support successful migration of AIDS orphans in southern Africa

Abstract

Most southern African orphans are cared for by extended families but the implications of the spatial dispersal of such families are seldom recognised: orphans often have to migrate to new homes and communities. This paper, based on qualitative research conducted with children and guardians in urban and rural Lesotho and Malawi, examines orphans' migration experiences in order to assess how successful migration might best be supported.Most children found migration traumatic in the short term, but over time many settled into new environments. Although much AIDS policy in southern Africa stresses the role of communities, the burden of care lay with extended family households. Failed migrations, which resulted in renewed migration and trauma, were attributable to one of two household-level causes:orphans feeling ill-treated in their new families or changes in guardians' circumstances.Policy interventions to reduce disruption and trauma for young AIDS migrants should aim at facilitating sustainable arrangements by enabling suitable households to provide care.Reducing the economic costs of caring for children, particularly school-related costs, would: allow children to stay with those relatives (e.g. grandparents) best able to meet their nonmaterial needs; reduce resentment of foster children in impoverished households; and diminish the need for multiple migrations.2 Enabling households to support successful migration of AIDS orphans in southern Africa Background

Socio-demographic determinants of health support services among orphans and vulnerable children in Nigeria

“…Therefore, this study supports other studies including those of Foster and Germann (2002), Harber (2009) and Datta (2013) that proposed community-based care as viable approach to taking care of orphans and vulnerable children as it places children at the centre of all development programmes, ensures different levels of community ownership and participation (Ansell and Young, 2004;Sanou et al, 2009) and believed to be the most cost-effective strategy for providing care and support to OVC but proposes that interventions on service provision for OVC should be integrated into other programs such as the Hard-to-Reach (HTR) programs and the new Community Health Influencers, Promoters and Services (CHIPS) program Community Health Influencers, Promoters and Services (CHIPS) program (Adebayo, 2017) as this would help improve service provision to households, case management, tracking, monitoring and follow-up of services and militate against the influence of socio-demographic factors such as Victor 169 region of residence.…”

Growing up HIV-positive in Uganda: “psychological immunodeficiency”? A qualitative study

“…As the focus of the study was the experienced life world of the adolescents, a phenomenological approach [24] was chosen for the analysis. Prior assumptions (like the indisputable value of the extended family) were bracketed off, while the interview was broken down into relevant meaning units and interpreted in a hermeneutical circle between the parts and the whole interview.…”

“…The children and adolescents thus have to live with the constant threat of double orphan hood and an unpredictable future in addition to their own chronic condition and sometimessevere physical problems. Ansell & Young [24] have shown that most orphans despite multiple migrations, which they in the beginning feel traumatic, settle in. Despite this positive finding we have to question whether the volatile family environment in which the children and adolescents live has influenced their development.…”

“…Moreover, Ansell & Young [24] have in their studies in Lesotho and Malawi shown that most orphans experience multiple migrations and that they in the beginning feel this traumatic, but in the long term settle in. Given all these challenges both in their past, actual situation and future, it is important to study the adolescents' own experiences of their situation, especially as approximately half of the HIV-infected adolescents display symptoms that are consistent with behavioral and mood disorders.…”

Life history analysis of HIV/AIDS-affected households in rice and cassava-based farming communities in Northern Malawi

“…Deaths from a variety of causes already were among the most serious threats in rural Malawi prior to the onset of the epidemic (Mtika 2000). These contexts, together with the importance of children and efforts to minimize migration (Ansell and Young 2004), need to be recognised in public health programming.…”