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Exavery A, Charles J, Kuhlik E, Barankena A, Koler A, Kikoyo L, Jere E. Understanding the association between caregiver sex and HIV infection among orphans and vulnerable children in Tanzania: learning from the USAID Kizazi Kipya project. BMC Health Serv Res 2020; 20:275. [PMID: 32245468 PMCID: PMC7119283 DOI: 10.1186/s12913-020-05102-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/11/2020] [Indexed: 11/22/2022] Open
Abstract
Background Tanzania has met only 50.1% of the 90% target for diagnosing HIV in children. The country’s pediatric case finding strategy uses global best practices of index testing, provider-initiated counselling and testing, and targeted community testing of at-risk populations to find about 50,000 children living with HIV (CLHIV) who are undiagnosed. However, context-specific strategies are necessary to find the hidden children to meet the full 90% target. This study assesses whether sex of the caregiver is associated with HIV status of orphans and vulnerable children (OVC) as a valuable strategy for enhanced pediatric case findings. Methods Data originate from the community-based, United States Agency for International Development (USAID)-funded Kizazi Kipya Project, which works towards increasing OVC’s and their caregivers’ uptake of HIV/AIDS and other health and social services in Tanzania. Included in this study are 39,578 OVC ages 0–19 years who the project enrolled during January through March 2017 in 18 regions of Tanzania and who voluntarily reported their HIV status. Data analysis involved multi-level logistic regression, with OVC HIV status as the outcome of interest and caregiver’s sex as the main independent variable. Results Three-quarters (74.3%) of the OVC included in the study had female caregivers, and their overall HIV prevalence was 7.1%. The prevalence was significantly higher (p < 0.001) among OVC with male caregivers (7.8%) than among OVC with female caregivers (6.8%), and indeed, multivariate analysis showed that OVC with male caregivers were significantly 40% more likely to be HIV-positive than those with female caregivers (OR = 1.40, 95% CI 1.08–1.83). This effect was the strongest among 0–4 year-olds (OR = 4.02, 95% CI 1.61–10.03), declined to 1.72 among 5–9 year-olds (OR = 1.72, 95% CI 1.02–2.93), and lost significance for children over age 9 years. Other significant factors included OVC age and nutritional status; caregiver HIV status and marital status; household health insurance status, and family size; and rural versus urban residence. Conclusions OVC in Tanzania with male caregivers have a 40% higher likelihood of being HIV-positive than those with female caregivers. HIV risk assessment activities should target OVC with male caregivers, as well as OVC who have malnutrition, HIV-positive caregivers, or caregivers who do not disclose their HIV status to community volunteers. Further, younger HIV-positive OVC are more likely to live in rural areas, while older HIV-positive OVC are more likely to live in urban areas. These factors should be integrated in HIV risk assessment algorithms to enhance HIV testing yields and pediatric case-finding in the OVC population in Tanzania.
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Affiliation(s)
| | | | - Erica Kuhlik
- Pact, Inc., 1828 L Street NW, Suite 300, Washington, DC, 20036, USA
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Zhang R, Chen L, Cui YD, Li G. Achievement of interventions on HIV infection prevention among migrants in China: A meta-analysis. SAHARA J 2018; 15:31-41. [PMID: 29564968 PMCID: PMC5917330 DOI: 10.1080/17290376.2018.1451773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In China, migrants with acquired immunodeficiency syndrome (AIDS) have become a serious problem in the field of AIDS prevention. This study aimed to evaluate the efficacy of interventions for human immunodeficiency virus (HIV) infection prevention for migrants in China and to identify factors associated with intervention efficacy. A computerized literature search of the Chinese National Knowledge Infrastructure, Wan Fang, and PubMed databases was conducted to collect related articles published in China. Only self-control intervention studies or studies containing sections regarding self-control interventions wherein the method of intervention was health education were included. Rev Manager 5.3 software was used to analyze the intervention effects in terms of knowledge, attitude, and behavior indexes. Relative to pre-intervention, the HIV interventions showed statistically significant efficacy in terms of sexual transmission of HIV, condom use for HIV prevention, change in attitude towards HIV/AIDS patients, incidence of commercial sex behavior, and recent condoms use during sex (P < .01). Moreover, the baseline rate of migrants, intervention time, peer education, region, and education background were factors influencing the efficacy of the intervention. Significant improvement in terms of knowledge of sexual transmission of HIV and attitudes and behaviors among migrants was observed; however, based on the findings of previous studies, the interventions should be customized for different people from different districts in China. Further research is needed to evaluate subgroups of migrants in China according to their baseline characteristics.
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Affiliation(s)
- Rui Zhang
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Ling Chen
- The Center of Experimental Teaching Management, Chongqing Medical University, Chongqing, 401331, People’s Republic of China
| | - Ya deng Cui
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Ge Li
- The Center of Experimental Teaching Management, Chongqing Medical University, Chongqing, 401331, People’s Republic of China
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Fakoya I, Álvarez‐Del Arco D, Monge S, Copas AJ, Gennotte A, Volny‐Anne A, Wengenroth C, Touloumi G, Prins M, Barros H, Darling KEA, Prestileo T, Del Amo J, Burns FM. HIV testing history and access to treatment among migrants living with HIV in Europe. J Int AIDS Soc 2018; 21 Suppl 4:e25123. [PMID: 30027686 PMCID: PMC6053481 DOI: 10.1002/jia2.25123] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 05/16/2018] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Migrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe. METHODS A cross-sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV-positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign-born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men. RESULTS A total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post-migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three-quarters of people on antiretrovirals had an HIV viral load <50 copies/mL. CONCLUSIONS Migrants access healthcare in Europe and while many migrants had previously tested for HIV, that they went on to test positive at a later date suggests that opportunities for HIV prevention are being missed. Expansion of testing beyond sexual health and antenatal settings is still required and testing opportunities should be linked with combination prevention measures such as access to PrEP and treatment as prevention.
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Affiliation(s)
- Ibidun Fakoya
- Institute for Global HealthUniversity College LondonLondonUnited Kingdom
| | | | - Susana Monge
- Department of Health and Socio‐medical SciencesUniversity of AlcaláAlcalá de HenaresMadrid
| | - Andrew J Copas
- Institute for Global HealthUniversity College LondonLondonUnited Kingdom
| | | | | | | | - Giota Touloumi
- Department of Hygiene, Epidemiology& Medical StatisticsMedical SchoolNational and Kapodistrian University of AthensAthensGreece
| | - Maria Prins
- Academic Medical CentreUniversity of AmsterdamAmsterdamthe Netherlands
- Public Health Service of Amsterdamthe Netherlands
| | | | | | - Tullio Prestileo
- Unit for Infectious Diseases and Assistance, Coordination and Territorial Integration for Migrants’ EmergencyCivico‐ Benfratelli HospitalPalermoItaly
| | - Julia Del Amo
- National Centre of EpidemiologyInstituto de Salud Carlos IIIMadridSpain
| | - Fiona M Burns
- Institute for Global HealthUniversity College LondonLondonUnited Kingdom
- Royal Free London NHS Foundation TrustLondonEngland
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Intergenerational care for and by children: Examining reciprocity through focus group interviews with older adults in rural Uganda. DEMOGRAPHIC RESEARCH 2018. [DOI: 10.4054/demres.2018.38.63] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Arrey AE, Bilsen J, Lacor P, Deschepper R. Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium. PLoS One 2016; 11:e0159488. [PMID: 27447487 PMCID: PMC4957758 DOI: 10.1371/journal.pone.0159488] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 07/04/2016] [Indexed: 01/09/2023] Open
Abstract
Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA) migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking "why me?" A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into consideration in providing a caring and healthy environment.
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Affiliation(s)
- Agnes Ebotabe Arrey
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- * E-mail:
| | - Johan Bilsen
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Patrick Lacor
- Department of Internal Medicine and Infectious Diseases-AIDS Reference Center, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Reginald Deschepper
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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Abstract
An estimated 58 million persons aged 60-plus live in sub-Saharan Africa; by 2050 that number will rise sharply to 215 million. Older Africans traditionally get care in their old age from the middle generation. But in East and Southern Africa, HIV has hollowed out that generation, leaving many older persons to provide care for their children's children without someone to care for him or herself in old age. Simultaneously, the burden of disease among older persons is changing in this region. The result is a growing care deficit. This article examines the existing literature on care for and by older persons in this region, highlighting understudied aspects of older persons' experiences of ageing and care--including the positive impacts of carework, variation in the region and the role of resilience and pensions. We advance a conceptual framework of gendered identities--for both men and women--and intergenerational social exchange to help focus and understand the complex interdependent relationships around carework, which are paramount in addressing the needs of older persons in the current care deficit in this region, and the Global South more generally.
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Affiliation(s)
- Enid Schatz
- a Department of Health Sciences , University of Missouri , Columbia , MO , USA.,b Institute of Behavioral Science , University of Colorado , Boulder , CO , USA.,c MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Janet Seeley
- d Social Science Programme , MRC/UVRI Uganda Research Unit on AIDS , Entebbe , Uganda.,e Department of Global Health and Development , London School of Hygiene and Tropical Medicine , London , UK
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Kranzer K, Meghji J, Bandason T, Dauya E, Mungofa S, Busza J, Hatzold K, Kidia K, Mujuru H, Ferrand RA. Barriers to provider-initiated testing and counselling for children in a high HIV prevalence setting: a mixed methods study. PLoS Med 2014; 11:e1001649. [PMID: 24866209 PMCID: PMC4035250 DOI: 10.1371/journal.pmed.1001649] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 04/16/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND There is a substantial burden of HIV infection among older children in sub-Saharan Africa, the majority of whom are diagnosed after presentation with advanced disease. We investigated the provision and uptake of provider-initiated HIV testing and counselling (PITC) among children in primary health care facilities, and explored health care worker (HCW) perspectives on providing HIV testing to children. METHODS AND FINDINGS Children aged 6 to 15 y attending six primary care clinics in Harare, Zimbabwe, were offered PITC, with guardian consent and child assent. The reasons why testing did not occur in eligible children were recorded, and factors associated with HCWs offering and children/guardians refusing HIV testing were investigated using multivariable logistic regression. Semi-structured interviews were conducted with clinic nurses and counsellors to explore these factors. Among 2,831 eligible children, 2,151 (76%) were offered PITC, of whom 1,534 (54.2%) consented to HIV testing. The main reasons HCWs gave for not offering PITC were the perceived unsuitability of the accompanying guardian to provide consent for HIV testing on behalf of the child and lack of availability of staff or HIV testing kits. Children who were asymptomatic, older, or attending with a male or a younger guardian had significantly lower odds of being offered HIV testing. Male guardians were less likely to consent to their child being tested. 82 (5.3%) children tested HIV-positive, with 95% linking to care. Of the 940 guardians who tested with the child, 186 (19.8%) were HIV-positive. CONCLUSIONS The HIV prevalence among children tested was high, highlighting the need for PITC. For PITC to be successfully implemented, clear legislation about consent and guardianship needs to be developed, and structural issues addressed. HCWs require training on counselling children and guardians, particularly male guardians, who are less likely to engage with health care services. Increased awareness of the risk of HIV infection in asymptomatic older children is needed.
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Affiliation(s)
- Katharina Kranzer
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jamilah Meghji
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Ethel Dauya
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | - Joanna Busza
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Khameer Kidia
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Hilda Mujuru
- Department of Paediatrics, University of Zimbabwe, Harare, Zimbabwe
| | - Rashida A. Ferrand
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
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Douab T, Marcellin F, Vilotitch A, Protopopescu C, Préau M, Suzan-Monti M, Sagaon-Teyssier L, Lert F, Carrieri MP, Dray-Spira R, Spire B. Health-related quality of life of people living with HIV followed up in hospitals in France: comparing trends and correlates between 2003 and 2011 (ANRS-VESPA and VESPA2 national surveys). AIDS Care 2014; 26 Suppl 1:S29-40. [DOI: 10.1080/09540121.2014.906553] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Taoufiq Douab
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - Fabienne Marcellin
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - Antoine Vilotitch
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - Camelia Protopopescu
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - Marie Préau
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
- Groupe de Recherche en Psychologie Sociale, Institut de Psychologie, Université Lyon 2, Bron, France
| | - Marie Suzan-Monti
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - Luis Sagaon-Teyssier
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - France Lert
- Centre de recherche en épidémiologie et santé des populations, Hôpital Paul Brousse, Inserm U1018, Villejuif, France
- Université de Versailles Saint-Quentin-en-Yvelines, UMRS 1018, Villejuif, France
| | - Maria Patrizia Carrieri
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - Rosemary Dray-Spira
- Centre de recherche en épidémiologie et santé des populations, Hôpital Paul Brousse, Inserm U1018, Villejuif, France
- Université de Versailles Saint-Quentin-en-Yvelines, UMRS 1018, Villejuif, France
| | - Bruno Spire
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France
- Aix Marseille Université, UMR_S912, IRD, 13006, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006, Marseille, France
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Morantz G, Cole D, Vreeman R, Ayaya S, Ayuku D, Braitstein P. Child abuse and neglect among orphaned children and youth living in extended families in sub-Saharan Africa: What have we learned from qualitative inquiry? VULNERABLE CHILDREN AND YOUTH STUDIES 2013; 8:338-352. [PMID: 24563656 PMCID: PMC3929282 DOI: 10.1080/17450128.2013.764476] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Researchers and aid organizations have reported that orphans in sub-Saharan Africa (SSA) are particularly vulnerable to abuse and neglect. This article is a review of qualitative studies that address experiences of maltreatment among orphaned children and youth living in extended families in SSA. It aims to inform policy and programming by providing a better understanding of the types of maltreatment encountered and the perceived risk factors. A literature search was carried out using Google, PubMed, Scholars Portal Search and Scopus. Searches of relevant bibliographies and publications of authors were also undertaken. Studies from peer-reviewed journals and the grey literature were reviewed for relevance and quality. Eligible studies had to include orphans living with extended family in SSA as participants, explore their maltreatment experiences and employ a sound qualitative methodology. Findings were coded, extracted, compared and synthesized. Twenty articles, representing 15 studies, were selected. These studies, from diverse SSAn countries, reported similar forms of maltreatment among orphaned children and youth: experiences of intra-household discrimination; material and educational neglect; excessive child labour; exploitation by family members and psychological, sexual and physical abuse. The perceived risk factors were poverty, living with a non-biological caregiver, stigma and alcohol abuse. The findings of the included studies suggest that awareness, prevention and intervention initiatives aimed to curb child abuse and neglect within communities in SSA are needed and should be coupled with efforts to promote education and reduce poverty and stigma.
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Affiliation(s)
- Gillian Morantz
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
- Corresponding author.
| | - Donald Cole
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Vreeman
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Samuel Ayaya
- School of Medicine, Moi University, Eldoret, Kenya
| | - David Ayuku
- School of Medicine, Moi University, Eldoret, Kenya
| | - Paula Braitstein
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- School of Medicine, Moi University, Eldoret, Kenya
- Academic Model Providing Access to Healthcare Partnership, United States Agency for International Development, Eldoret, Kenya
- Regenstrief Institute, Indianapolis, IN, USA
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Ebersöhn L, Ferreira R. Coping in an HIV/AIDS-dominated context: teachers promoting resilience in schools. HEALTH EDUCATION RESEARCH 2011; 26:596-613. [PMID: 21441389 DOI: 10.1093/her/cyr016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This paper explains how teachers in schools function as resources to buoy resilience in the face of human immunodeficiency virus/acquired immune deficiency syndrome-compounded adversities. We draw on participatory reflection and action data from a longitudinal study with teachers (n = 57, 5 males, 52 females) from six schools in three South African provinces. The study tracks the psychosocial support offered by teachers following their participation in the Supportive Teachers, Assets and Resilience project. Verbatim interview transcriptions were thematically analysed and three themes (as well as subthemes and categories) emerged: (i) Teachers use resources to promote resilience in schools [teachers use (a) systems and (b) neighbourhood health and social development services to identify and refer vulnerable cases]; (ii) Teachers form partnerships to promote resilience in schools [teacher partnerships include (a) children and families, (b) community volunteers and (c) community organizations, businesses and government] and (iii) School-based support is offered to vulnerable individuals [by means of (a) vegetable gardens, (b) emotional and health support and (c) capacity development opportunities]. We conclude that teachers can promote resilience in schools by establishing networks with service providers that function across systems to support vulnerable groups. We theorize that the core of systemic networks is relationships, that relationship-driven support networks mitigate the effects of cumulative risk and school-based networks can enable schools to function as resilience-promoting resources.
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Affiliation(s)
- Liesel Ebersöhn
- Unit for Education Research in AIDS, Faculty of Education, University of Pretoria, Pretoria 0002, South Africa.
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