Application of community participation paradigm in the care of children orphaned by HIV and AIDs in Kibera Division, Nairobi, Kenya.
Akunga, Alice Bonareri
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Literature reviewed indicates that community care programmes have been initiated to support children orphaned by HIV and AIDS. These children suffer from various problems, including loss of family, depression, malnutrition, lack of access to education and healthcare; loss of property and inheritance; abuse and increased exposure to HIV and AIDS. However, there is no information on gender relationship in their needs, care, and problems faced. There is also no information on community participation in the care programmes assisting orphaned children, and the success of these community programmes in meeting orphan needs. Neither is there any information on the relationships between the orphans being supported by these community care programmes and those without any support, issues that this study sought to address. This study applied community participation paradigm in community care programmes providing care to HIV and AIDS orphans in Kibera Location, Nairobi, Kenya. This paradigm emphasizes and strengthens the role of the community in community programmes. It emphasizes that involvement of the community members in planning and implementation of these programmes enhances ownership and therefore leads to success of these programmes. The study is also supported by the double ABCX model, which describes factors that account for differences in family capability to achieve a new level of balance at both the individual family and the family-community level over time after a situation affecting the family occurs. The study therefore sought to establish community participation in care programmes, as well as the success of these programmes in meeting the needs of orphans. A random sample of 219 orphans and caregivers (55 from a community care programme and 164 not under the programme); 11 community leaders and 13 community care programme leaders in Kibera Location, Nairobi, was surveyed using interviews and focus group discussions. The findings of this study showed that orphan needs for food, clothing, medical care, shelter, education and psychosocial support are not adequately provided for. Findings further showed that the orphans experienced a number of problems, including hunger, inadequate shelter and clothing; being overworked, beaten and quarrelled. The results further indicate that very few caregivers were involved in community care projects. For instance, only 5% of caregivers were involved in planning the activities of community care programmes, while only 2.7% are involved in decision-making. Additionally, very few (17.3%) of caregivers were involved in carrying out activities of the community care programmes, which mostly involves reaching out to orphans and offering home based care and support. At the same time, only 6.8% of caregivers made contributions towards supporting community care programmes. Overall, 56.2% of the caregivers felt that community care programmes were not sufficiently meeting orphan needs, hence.not successful, while only 8.2% felt that the programmes were successful in .meeting needs of orphans. The rest, 35.6%, felt that the needs of orphans were fairly sufficiently met. There were significant relationships between gender of orphans and assistance required in school fees, with more girls requiring support in school fees. Significant relationships were also observed between orphans in and out of the project and problems of hunger, inadequate clothing and being overworked. The majority of orphans out of the project were overworked. Correlation results show success of community care programmes and, the number of orphans, support provided, needs and problems of the ophans and problems experienced by caregivers. Community participation variables also showed significant relationship with success of community care programmes. The study findings further show that the number of HIV and AIDS orphans and number of problems experienced by caregivers are predictors of success of community care programmes. Based on the findings of this study, there is a need for programmes designed to assist orphans to have an integrated approach towards assisting orphans, thereby striving to XVI provide for all their needs adequately and checking against any abuses. There is also a need to design programmes to support caregivers and communities affected particularly those without any assistance. In addition, it is important to involve the communities and in particular caregivers in the activities of the community care programmes. It is also important to establish home based care support programmes, establish orphan support networks and advise and encourage parents who are infected with IllV and AIDS to engage and discuss with their children about their future.