Text in English / Background: Children living in child-headed households have health needs that require treatment and care. Matsanjeni is one of the poorest socio-economic areas of Swaziland with the high number of children orphaned by HIV and AIDS who are often living without adequate family and social supports. These conditions are known for increasing people vulnerability to diseases and hindering access and utilization of health services. However, children living in child-headed households in Matsajeni community do attend the primary health care (PHC) services on regular basis. What influence the utilization of the above services by children living in child-headed households in the Matsanjeni community is not clear and well documented. Aim of the study: To explore and describe the views of children living in child-headed households in a rural community of Swaziland regarding factors influencing their utilization of PHC services. Design: A qualitative descriptive design was used to guide the study. Purposive sampling was used to select the most senior child from child-headed households in a rural community. Semi-structured individual face-to-face interviews were used to generate data. Data saturation was reached after twenty interviews. Thematic content analysis was used to analyse data. The researcher used Andersen behavioural model was to identify and organised the emerged themes. Ethical clearance was obtained from the Ethics Committees of the University of South Africa and the Ministry of Health of Swaziland. Results: Fear to develop a deadly disease, perceived seriousness of the condition, desire for compliance to medical treatment, and community support emerged as enablers of primary health care services utilisation among children living in child-headed households. While lack of money, ignorance, shortage of healthcare personnel, negative behaviour and attitude of health professionals, long waiting hours, unreliable transportation system, and long distance emerged as inhibitors of primary health care services utilisation among children living in child-headed households. Conclusion and recommendation: The results of this study add to our understanding factors that positively and negatively influence the utilisation of primary health care services among children living in child-headed households in rural communities. The findings suggest that the utilisation of primary health care services among children living in child-headed households is influenced by need for care-enabling resources-experience of care triad. Behavioural and social welfare interventions are needed to enhance the utilisation of primary health care services among this vulnerable section of the community in Swaziland. Recommendation for further research is also articulated. / Health Studies / M.A. (Public Health)

The family as the basic unit of society plays an important role in the lives of individuals especially children. The HIV/AIDS epidemic has devastated the family structure which is already strained by other detrimental factors such as urbanisation and poverty. The increased death rate of young parents due to AIDS-related diseases has led to an escalating number of orphaned children growing in child headed households (CHH) without adult care. A qualitative study was undertaken to develop an understanding of the barriers that hinder the integration of orphaned children into extended family folds and to obtain suggestions on how to overcome these barriers. Semi-structured, face-to-face interviews were conducted in Bushbuckridge, Mpumalanga Province, with a sample of children heading CHH, relatives of these children and social workers who were rendering social work services to these client-systems. The study revealed that the level of suffering faced by CHH began with the illness of the parents. This was further exacerbated by the death of the parents as these children were not absorbed by their extended families. Barriers that hindered the integration of orphaned children into extended family folds go beyond the extended families’ economic capacity to absorb the children. There is an interplay of barriers that are poverty related, relational and family related, culturally related, circumstances that are related to the orphaned children as well as limitations in social work service delivery. The findings indicate that CHH is not a good option to care and protect orphaned children as it exposes them to pervasive adversities with little resources and support. The integration of orphaned children is embraced as a good option to care for the children because of its potential value, amongst others, of enabling the extended families to relieve the CHH from the burden of care. From the findings of this study, practice guidelines were developed to enhance the efficacy of integrating orphaned children into extended families to prevent the CHH phenomenon.

Text in English / Background: Children living in child-headed households have health needs that require treatment and care. Matsanjeni is one of the poorest socio-economic areas of Swaziland with the high number of children orphaned by HIV and AIDS who are often living without adequate family and social supports. These conditions are known for increasing people vulnerability to diseases and hindering access and utilization of health services. However, children living in child-headed households in Matsajeni community do attend the primary health care (PHC) services on regular basis. What influence the utilization of the above services by children living in child-headed households in the Matsanjeni community is not clear and well documented. Aim of the study: To explore and describe the views of children living in child-headed households in a rural community of Swaziland regarding factors influencing their utilization of PHC services. Design: A qualitative descriptive design was used to guide the study. Purposive sampling was used to select the most senior child from child-headed households in a rural community. Semi-structured individual face-to-face interviews were used to generate data. Data saturation was reached after twenty interviews. Thematic content analysis was used to analyse data. The researcher used Andersen behavioural model was to identify and organised the emerged themes. Ethical clearance was obtained from the Ethics Committees of the University of South Africa and the Ministry of Health of Swaziland. Results: Fear to develop a deadly disease, perceived seriousness of the condition, desire for compliance to medical treatment, and community support emerged as enablers of primary health care services utilisation among children living in child-headed households. While lack of money, ignorance, shortage of healthcare personnel, negative behaviour and attitude of health professionals, long waiting hours, unreliable transportation system, and long distance emerged as inhibitors of primary health care services utilisation among children living in child-headed households. Conclusion and recommendation: The results of this study add to our understanding factors that positively and negatively influence the utilisation of primary health care services among children living in child-headed households in rural communities. The findings suggest that the utilisation of primary health care services among children living in child-headed households is influenced by need for care-enabling resources-experience of care triad. Behavioural and social welfare interventions are needed to enhance the utilisation of primary health care services among this vulnerable section of the community in Swaziland. Recommendation for further research is also articulated. / Health Studies / M.A. (Public Health)

The changing structures of families and the increase in the number of child headed families are progressively becoming noticeable both nationally and internationally. Reviewed literature has confirmed that the increasing trend in orphan status among school going age over the period 2002-2009, is of major concern. A growing body of literature also indicates that child headed families and orphan hood are becoming common phenomena in many African countries in general and South Africa in particular. This scenario presents certain challenges especially on the orphaned children‘s learning and schooling experiences as well as their behavioural and social interaction patterns. The phenomenon calls for greater educational support for such learners at school and home. Increasingly, teachers and schools world over are expected to respond to the changing educational environment and contextual realities of schooling that include the orphaned learners who head households. The aim of this thesis was to address the behavioural challenges that orphaned learners who head household experience and to develop a psycho-educational programme to support their learning. A qualitative instrumental case study research design was used with a study sample of 30 orphaned learners living in child headed household aged 10 to 16 years, ten Life Orientation Teachers, four members of School Management Team, eight members of School Based Support Team (SBST) and four Social Workers who were purposively sampled to participate in the study. The study was conducted in 15 classes located at four schools (3 secondary, 1 primary) in Taledi Area, Mamusa Circuit located in Ipelegeng Township of Schweizer Reneke town under Dr R.S. Ruth Momphati District-North West Province, South Africa. In order to answer the research question, data was collected using a variety of data collection techniques. These were semi structured interviews, observations and documentary analysis. Data obtained was analysed using the interpretational analysis method to determine the common themes and sub themes describing the behavioural challenges that the orphaned learners experience during schooling in the playgrounds and in the classroom. Data analysed revealed that although orphaned learners are socially strong with regard to interaction with their peers, they experience learning difficulties in the classroom leading to underperformance and grade repeating. The study also noted that orphaned learners exhibit negative conduct behaviours and negative social interaction patterns with their LO teachers and members of the school management team. The study also revealed that emotional problems and lack of material support are common phenomena amongst these learners. The study arrived at the recommendation that a psycho-educational programme to address the behavioural challenges be developed to enhance the academic performance of the learners. / Psychology of Education / D. Ed. (Psychology of Education)

A distressing consequence of the HIV/AIDS pandemic and of the increasing numbers of orphans and decreasing numbers of caregivers is the emergence in ever larger numbers of child-headed households (CHHs). The complexity of issues affecting CHHs and the lack of research on this subject means that CHHs are not well understood. This sometimes prompts support agencies to provide emotionally driven recommendations suggesting that it is better for a child to be in an orphanage than to live in a CHH. This exploratory study, involving heads of 105 CHHs over a 12 month period and 142 participants in various focus group discussions (FGD) and interviews, suggests the need for a change in perspective. It addresses the question of CHH quality of life, coping strategies and household functioning and attempts to bring this into a productive dialogue with community child care activities, NGO and statutory support and child care and protection policies. Research data suggests that the key determining factor contributing towards the creation of a CHH is `pre-parental illness' family conflict. Another contributing factor is that siblings want to stay together after parental death. Quality of life assessments indicate that despite significant adversities, over 69% of CHHs reported a 'medium' to 'satisfactory' quality of life and demonstrate high levels of resilience. As regards vulnerability to abuse, it is found that while CHH members are more vulnerable to external abuse, they experience little within their household. Contrary to public perceptions about CHHs lacking moral values, CHH behaviour might actually be more responsible than non-CHH peer behaviour as their negative experiences appear to galvanize them into adopting responsible behaviour. Community care and neighbourhood support in older townships are better established compared with newer suburbs. Sufficient community care capacity enables CHHs to function, thus avoiding a situation where households disintegrate and household members end up as street children. CHH coping responses seem to be mainly influenced by individual and community factors, and by social, spiritual and material support. The interplay between these and the CHH's ability to engage in the required coping task impacts on the coping outcome at household level. National and international government and non-governmental child service providers in Southern Africa need to recognize that an adequately supported CHH is an acceptable alternative care arrangement for certain children in communities with high adult AIDS mortality and where adult HIV-prevalence exceeds 10%. / Development Studies / D. Ltt. et Phil. (Development Studies)

The scourge of HIV/AIDS is ravaging our communities; many children have lost their parents to this pandemic. The death of parents because of this pandemic has resulted in the emergence of a new phenomenon of child-headed households. This paper seeks to examine the rights of children in child-headed households as entrenched in section 28(1)(b) and (c) of the Constitution. Once the rights of children in child-headed households are ascertained, the state’s duty to give effect to these rights is investigated. In the analysis of the rights, the socio-economic rights jurisprudence of the Constitutional Court is considered. The paper further argues that the state gives effect to the rights of children in child-headed households through legislation and policy. As such, the paper takes a closer look at the legislation and policies that seek to give effect to the rights of children in child-headed households as enumerated in section 28(1)(b) and (c) and gaps in that legislation and policy are highlighted. In conclusion, proposals are made that will assist the state to give effect to the rights of children in child-headed households as set out in the Constitution. / Private Law / LL.M.

A distressing consequence of the HIV/AIDS pandemic and of the increasing numbers of orphans and decreasing numbers of caregivers is the emergence in ever larger numbers of child-headed households (CHHs). The complexity of issues affecting CHHs and the lack of research on this subject means that CHHs are not well understood. This sometimes prompts support agencies to provide emotionally driven recommendations suggesting that it is better for a child to be in an orphanage than to live in a CHH. This exploratory study, involving heads of 105 CHHs over a 12 month period and 142 participants in various focus group discussions (FGD) and interviews, suggests the need for a change in perspective. It addresses the question of CHH quality of life, coping strategies and household functioning and attempts to bring this into a productive dialogue with community child care activities, NGO and statutory support and child care and protection policies. Research data suggests that the key determining factor contributing towards the creation of a CHH is `pre-parental illness' family conflict. Another contributing factor is that siblings want to stay together after parental death. Quality of life assessments indicate that despite significant adversities, over 69% of CHHs reported a 'medium' to 'satisfactory' quality of life and demonstrate high levels of resilience. As regards vulnerability to abuse, it is found that while CHH members are more vulnerable to external abuse, they experience little within their household. Contrary to public perceptions about CHHs lacking moral values, CHH behaviour might actually be more responsible than non-CHH peer behaviour as their negative experiences appear to galvanize them into adopting responsible behaviour. Community care and neighbourhood support in older townships are better established compared with newer suburbs. Sufficient community care capacity enables CHHs to function, thus avoiding a situation where households disintegrate and household members end up as street children. CHH coping responses seem to be mainly influenced by individual and community factors, and by social, spiritual and material support. The interplay between these and the CHH's ability to engage in the required coping task impacts on the coping outcome at household level. National and international government and non-governmental child service providers in Southern Africa need to recognize that an adequately supported CHH is an acceptable alternative care arrangement for certain children in communities with high adult AIDS mortality and where adult HIV-prevalence exceeds 10%. / Development Studies / D. Ltt. et Phil. (Development Studies)

Text in English / Child-headed households are a reality in South Africa, and extensive research has advanced its causes and the children’s coping mechanisms. Social workers identify children in need, refer them to SASSA for social grants, facilitate foster care placements and offer psychosocial support services. This study sought to determine the nature of social work services rendered to children in such households in Virginia in the Free State. Qualitative exploratory, descriptive and contextual research was used to reach the goal of the study. Thirteen semi-structured interviews were conducted with thirteen participants who were selected through purposive sampling. The data collected was analysed using the eight steps of Tesch (in Creswell, 2009) and verified through Guba’s method of trustworthiness (Krefting, 1991). The services rendered to child-headed households (CHHs) through individual, group and community work were inadequate due to lack of resources including a shortage of social workers due to a general dissatisfaction with salaries. Participants suggested the need to build the capacity of the available staff through staff training and improved access to available resources in order to strengthen the nature of services rendered to CHHs. / Social Work / M.A. (Social Work)

The scourge of HIV/AIDS is ravaging our communities; many children have lost their parents to this pandemic. The death of parents because of this pandemic has resulted in the emergence of a new phenomenon of child-headed households. This paper seeks to examine the rights of children in child-headed households as entrenched in section 28(1)(b) and (c) of the Constitution. Once the rights of children in child-headed households are ascertained, the state’s duty to give effect to these rights is investigated. In the analysis of the rights, the socio-economic rights jurisprudence of the Constitutional Court is considered. The paper further argues that the state gives effect to the rights of children in child-headed households through legislation and policy. As such, the paper takes a closer look at the legislation and policies that seek to give effect to the rights of children in child-headed households as enumerated in section 28(1)(b) and (c) and gaps in that legislation and policy are highlighted. In conclusion, proposals are made that will assist the state to give effect to the rights of children in child-headed households as set out in the Constitution. / Private Law / LL.M.

The qualitative research approach, applying an explorative, descriptive and contextual strategy of enquiry was used to address the research question formulated, - How do child and youth care workers support child-headed households in the community? In this process the needs, relationships, interactions and encounters which occur between child and youth care workers and young people in child-headed households are described. The research was conducted with children from two child-headed households (12 children in all) and three community child and youth care workers from the Isibindi project in the province of Kwa-Zulu Natal. The findings confirm that the integration of child and youth care work characteristics in the daily life events of the children, contributed to services to children that are therapeutically caring, reclaiming and reflective of the African spirit of Ubuntu – demonstrating a relevant and unique South African expression of child and youth care practice. / Sociology / M. Tech. (Child and Youth Care)