Orphans and vulnerable youth in Bulawayo, Zimbabwe: An exploratory study of psychosocial well-being and psychosocial support

Abstract

Children and youth affected by AIDS typically face a wide range of stressful events and circumstances, including poverty, the loss of caregivers and loved ones, having to drop out of school, the burden of adultlike responsibilities, and social isolation. Increasingly programs for orphans and vulnerable children are addressing not only their material and educational needs, but their psychosocial needs as well. Yet there has been little research on how to evaluate psychosocial support (PSS) programs and the impact of these programs on vulnerable youth's psychosocial well-being. This report presents findings from an exploratory study by the Regional Psychosocial Support Initiative (REPSSI) and Catholic Relief Services' Support to Replicable, Innovative Village/Community-level Efforts (STRIVE) Program of vulnerable youth living in and around Bulawayo, Zimbabwe. It describes their demographic characteristics, exposure to stress and trauma, and psychosocial well-being. The report also highlights the relationships between psychosocial well-being outcomes and exposure to stress and trauma, and the differences in psychosocial well-being between males and females, orphaned and nonorphaned youth, and younger and older adolescents. In addition, the report explores the relationships between exposure to different psychosocial support programs and measures of psychosocial well-being and distress. The report concludes with program and research implications. Methods First, formative qualitative research was conducted with youth and adults working with youth to determine local concepts, manifestations, and domains of well-being among youth. These findings, together with input from local youth and international research experts and psychologists, were used to draft a quantitative survey. After pre-testing and finalizing the survey, the researchers administered it to a cross-sectional sample of 1,258 orphans and vulnerable youth, ages 14 to 20. All of the youth fell into one of three intervention groups, or into a fourth comparison group. The intervention groups included (1) youth exposed to community PSS, (2) youth exposed to the Salvation Army Masiye Camp, a residential PSS program, and (3) youth who attended Masiye Camp and went on to become youth peer leaders. Youth in the comparison group had not been exposed to any known PSS program. Data analysis was conducted in three stages to: (1) produce a profile of the sample, (2) determine relationships between psychosocial measures and demographic characteristics of the sample, and (3) explore associations between participation by youth in PSS interventions and psychosocial outcomes. The cross-sectional design of the study does not allow for establishing a causal relationship between program exposure and psychosocial well-being measures. But, using multiple regression analysis, the researchers were able to explore differences in select psychosocial well-being variables (e.g., self-Despite widespread trauma, daily stress, and psychosocial distress, many youth maintained selfconfidence,...

Community interventions providing care and support to orphans and vulnerable children: a review of evaluation evidence

“…At least one study [17] had aimed to conduct a baseline but was unable to do so due to logistical and resource constraints. Two of the studies AIDS Care 929 [5] Malawi Á Orphan Care Activities (Ledward et al, 2001) [6] Rwanda Á FXB Village Model (Desmond, 2007;Wilson & Berkman, 2007) [7] Rwanda Á Mentoring Youth-Headed Households (Brown et al, 2005;Boris et al, 2006;Horizons, 2007aHorizons, , 2007bThurman et al, 2006b) [8] South Africa Á Costing (Desmond & Gow, 2001;Desmond et al, 2002) [9] Tanzania Á CARE Tumaini Programme Assessment (Attawell et al, 2005;MEASURE Evaluation, 2007) [10] Tanzania Á Most Vulnerable Children (Mhamba, 2004) [11] Tanzania Á Vijana Simama Imara (VSI) (Clacherty & Donald, 2005) [16] Zambia Á Bwafwano Programme Chatterji et al, 2007;Dougherty et al, 2005) [17] Zambia Á Chikankata Programme (Mulenga, 2002) [18] Zambia Á Reaching AIDS-affected People with Integrated Development and Support (RAPIDS) (Population Council, 2006b;Population Council, 2008;RAPIDS, 2006;Schenk et al, 2008aSchenk et al, , 2008b [19] Zimbabwe Á Families, Orphans and Children Under Stress (FOCUS) (Drew et al, 1998;Foster et al, 1995;Foster et al, 1996;Foster et al, 1997aFoster et al, , 1997bFoster, 2002b;Lee, 1999;Lee et al, 2002) [20] Zimbabwe Á Psychosocial support interventions (Gilborn et al, 2006) n/a [16,18] employed multiple (two) rounds of data collection following intervention introduction, in order to track change trajectories during programme implementation. Without baseline data, four...…”

“…However, implementers and evaluators emphasise the need to be realistic about what such programmes can actually achieve: children devastated by traumatic loss may require more specialised individual attention (Horizons, 2007a) or families whose stress is a direct result of broader economic conditions may not see long-term improvements without broader policy responses addressing economic and sociocultural factors contributing to their distress (Gilborn et al, 2006). An important conclusion from implementers of programmes in this review (Drew, Makufa, & Foster, 1998;Foster, 2002b;Foster et al, 1996;SCOPE-OVC/Zambia & Family Health International/Zambia, 2003) and reiterated by authors from other settings (Beard, 2005;Bhargava & Bigombe, 2003;Desmond & Gow, 2002;Giese, Meintjes, Croke, & Chamberlain, 2003;Levine, Michaels, & Back, 1996;McKerrow, 1996;Mutangadura, Mukurazita, & Jackson, 1999;Richter, Manegold, & Pather, 2004;UNICEF, 2003;Williamson, 2005) is that without community motivation, longterm external funding, and technical support, community programmes are unsustainable; in any case implementers should be transparent about their exit strategy and/or plans for scale-up.…”

“…Lessons learnt include the importance of multisectoral collaborations between local government, community structures, and NGOs and faith-based organisations to avoid exhausting family and community goodwill (Christian Aid, United Nations Children's Fund [UNICEF], & Islamic Relief, 2006;Olson, Knight, & Foster, 2006;Tearfund, 2006); and of supporting linkages between local service providers to develop referrals networks and connect with HIV prevention strategies (Esu-Williams, Duncan, Phiri, & Chilongozi, 2000;Horizons, 2007a). Promoting children's psychosocial wellbeing is a crucial priority requiring attention from trained caregivers (Gilborn et al 2006;Horizons, 2007a).…”

“…Strategies supporting orphaned and vulnerable children (OVC) are varied; they may include broad-based community-mobilisation initiatives (Donahue & *Email: kschenk@popcouncil.org Williamson, 1998;SCOPE-OVC/Zambia & Family Health International/Zambia, 2003), or specific components such as planning for children's fostering and preventing land-grabbing through will-writing (Horizons, Makerere University, & Plan/Uganda, 2004); providing psychosocial support (Gilborn et al, 2006); addressing poverty through incomegenerating activities (Donahue, 1998;Khonyongwa & ActionAid Malawi, 1998); or fostering HIV prevention behaviours (Gachuhi, 1999). Where possible, they are seen as preferable to institutional care, since they emphasise community self-reliance, build on traditional norms of extended family support, avoid separating children from their communities, and encourage local leaders to oversee child wellbeing (Beard, 2005;Phiri, Foster, & Nzima, 2001;Strebel, 2004;Williamson, 2004).…”

Do Social Support, Self-efficacy and Resilience Influence the Experience of Stress in Ghanaian Orphans? An Exploratory Study

“…It is plausible that relationships with friends served as a major source of social network and interaction for the present sample of Ghanaian orphans. Moreover, given that peer support serves as a protective factor against the adverse effects of parental loss and orphanage placement (Adamson & Roby, 2011;Adu, 2011;Emond, 2009;Gilborn et al, 2006), the stronger perceptions of support from friends need to be understood from the vantage point of peers being the readily available source of support and interaction. Interventions should therefore be aimed at psycho-educating orphans on the identification of important relationships, and strengthening those social ties and relationships that serve to promote well-being.…”