Devine, Sean (2005) The Child Friendly Schools project for AIDS affected children: an evaluative assessment in Northern Thailand. PhD thesis, James Cook University.

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Abstract

HIV/AIDS is one of the greatest threats to child development in many parts of the world. In the countries most affected by HIV/AIDS, all children are touched by the epidemic and their lives are affected in unprecedented ways. Families may experience a range of emotional reactions including fear of contagion, anticipatory grief, shame, and perceived helplessness, which can impede coping and create disruptions and relationship problems.

Further challenges, such as dealing with loss, uncertainty about the future, anxiety, sadness, anger, financial worries, and interpersonal stress, and an uncertain health support system are also common. Sadly, the struggle against real or perceived discrimination within their communities and even within families often reinforces their invisibility. Most children affected by HIV/AIDS tend to have limited access to health, education and welfare services. For the most vulnerable children, those whose parents are infected with HIV, care and support needs to start before children are orphaned. Their psychological support and acceptance in a non – discriminatory environment is just as important as their material needs. When considering the needs of children affected by HIV/AIDS, it is vital to recognise the importance of a supportive environment for a child’s survival and development. Effective interventions seek to listen to children and their families. They work to strengthen the capacities of children, families and communities to respond effectively.

This research is an inquiry into the effectiveness of a project that aimed to create prototype replicable models of rights-based, ‘Child-friendly’, schools that respond to the special needs of children in distress, develop psychosocial competencies, and promote healthy lifestyles and resilience in children and youth affected by AIDS in three districts of upper northern Thailand. Emphasis was placed on building the self- esteem and effectiveness of children, as they are crucial components for optimal growth and development. One of the aims of this research was to provide an understanding of the lives and needs of children affected by HIV/AIDS, particularly within Thai culture.

It is a thesis with two parts. In part one, pilot research highlighted the psychosocial problems that occur in a familial unit affected by HIV. This research was intended to provide a holistic insight into how HIV disrupts key areas that underpin a child’s development and social acceptance. Interpersonal relationships, grieving issues, communication, disclosure rates, acceptance in schools, orphan outcomes and the effects of AIDS stigma were investigated in-depth. Results suggest AIDS affected children suffer from a large array of problems that affect their wellbeing. Stigma and the sense of hopelessness associated with HIV/AIDS have the potential to greatly undermine the provision of care to children infected/affected by HIV/AIDS.

Recommendations suggest that support for children must be an integral part of programmes reaching parents with HIV/AIDS. Focus should not only be on orphaned children, it should be on all children who are vulnerable. The implementation of more child centred programmes is also recommended, as effective child-centred interventions do not focus on children alone, but consider the social context of their communities, the relationships within their families, as well as the structures and services that are in place to provide support to children.

Effective child-centred approaches are underpinned by a set of principles that view the child as a whole person, rather than as a set of separately defined needs. The second part of the thesis presents a child centred intervention, the ‘Child Friendly Schools’ project (CFS) that aimed to alleviate the psychological problems experienced by AIDS affected children. An evaluative assessment was undertaken on this project utilising a combination of both qualitative and quantitative techniques. Focus group discussions and art therapy sessions provided first hand, qualitative feedback. The case studies of three HIV affected children containing the stories of the families and communities are presented to further highlight the complexities experienced, and to provide personal feedback on the project.

Pre and post-test screens for depression and self-esteem provided an important situational analysis and a useful quantitative measure for determining if the project was effective in lowering depression and enhancing self-esteem. The results of the screening suggest a very noticeable improvement in the depression and self esteem levels of the children after a one-year period of project implementation. Overall results from both qualitative and psychological testing suggest that the CFS intervention had played a major role in improving the psychosocial wellbeing of AIDS affected children and those in difficult circumstances.

Item ID:	2142
Item Type:	Thesis (PhD)
Keywords:	HIV/AIDS, child development, psychosocial wellbeing, emotions, families, education, orphans, Thailand, child-friendly schools, evaluative assessment, art therapy, Rainbow Camps
Date Deposited:	09 Apr 2009 04:07
FoR Codes:	17 PSYCHOLOGY AND COGNITIVE SCIENCES > 1701 Psychology > 170113 Social and Community Psychology @ 0%
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