Learners affected and infected by HIV/AIDS have been given priority status in the development of inclusive education. The Department of Education should develop and support the personal and professional self of educators as torch bearers of its educational policy. This inquiry attempted to understand educators’ teaching experiences to establish what educational and psychological support was needed to better include such learners. The information obtained may enable District Based Support Team’s (DBST’s) and School Based Support Team’s (SBST’s), as well as educational psychologists to develop educators, as limited research has been done in this regard. In this inquiry the data collection methods included 16 questionnaires completed by educators, an individual interview with a principal as well as two focus group interviews (with educators, and then with SBST and School Management Teams (SMT’s) members combined). Collages were visual representations of educators’ experiences and aided group discussions. Data obtained was analysed using the constant comparative method to determine the common themes and sub themes describing educators’ experiences over and above the identified educational and psychological support they needed to better include child-headed family learners within their classrooms. The findings presented suggest orphan status awareness at schools cannot be taken for granted. In coping with the effects of orphan-hood, learners presented with characteristic barriers such as: learning difficulties, incomplete school work and homework, failure to participate, school absenteeism, hunger, concentration difficulties, tiredness and sleeping in class, neglected appearance, behavioural difficulties, signs of sexual abuse, and accelerated adulthood. Efforts to create supportive learning environments included: impartial treatment, learning support provision, accessing support services and meeting basic needs for food, clothing, love, belongingness, reassurance, motivation and encouragement. Educators iii related accompanying negative psychological experiences (i.e. feeling sadness, distress and pain, as well as being emotionally drained and experiencing a sense of frustration at not knowing how to help or feeling unable to help). Identified educational and psychological support included: capacity building through contextualized and customized in-service training programmes, financial incentives and motivation, improved resources, increased governmental involvement, accessing multidisciplinary support services, community support and self care. Educators need to be supported and developed within a framework of whole school development if the goals of building health promoting schools within an inclusive education system are to be realised. Recommendations included: (i) Compelling stakeholders and health professionals to inform school and district based support teams of a learner’s orphan status. (ii) Building pre-service and in-service capacities through modules or customized workshops, on the identification, support and referral of learners from child-headed homes, basic counselling skills as well as self care awareness and educator burn out. (iii) Schools must develop financial incentives and motivation schemes by fund raising, obtaining sponsorships and ‘granting leave’ to deserving educators. Resource sharing was also encouraged. (iv) Government should conduct needs analyses at grass roots level to ensure equitable support service provision relative to the number of learners from child-headed homes at a school. (v) Educational psychologists or school counselors on behalf of school based support teams can co-ordinate Community Building Approach principles as one way of sharing the burden of care amongst interested stakeholders and community members. / Prof. Jace Pillay

One of the challenges facing health care professionals today is the phenomenon of rendering care to children who have been orphaned in the AIDS pandemic. The number of AIDS orphans in South Africa has risen out of all proportion and is causing existing health and social structures to become stretched in providing care to this vulnerable population of children. The objectives of this study are to explore and to describe the lived experience of children living in a township who have become AIDS orphans and to develop broad guidelines for Primary Health Care Nurses (PHCN’s), related professionals and partners involved in the care of AIDS orphans living in a township. The theoretical grounding of this study is found in Kotze’s Theory on Nursing Accompaniment (Kotzé, 1998:3). The proposed research design was based upon a qualitative study using an explorative, descriptive, contextual and phenomenological strategy of inquiry. Data was collected by means of in-depth interviews from a purposively selected sample and then analysed using the steps of qualitative data analysis proposed by Tesch (in Creswell, 1994). Guba’s model was used to assess the trustworthiness of the qualitative data. Based upon the findings, guidelines were developed to assist PHCN’s related professionals and partners involved in the care of AIDS orphans living in a township. Through this study the goal of the researcher was to give a voice to AIDS orphans living in a township and to represent accurately their lived experience.

The human immunodeficiency virus/acquired immune-deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. “AIDS, (Acquired Immune Deficiency Syndrome), has devastated the social and economic fabric of African societies, made orphans of a whole generation of children and become the epicentre of the HIV/AIDS pandemic” (Fassin, 2007: 76). Like the virus itself, the AIDS crisis mutates rapidly. Children who are AIDS orphans living in South Africa, as in other African countries, suffer from recurrent psychological trauma. It starts with the illness and death of their parents and is followed by cycles of poverty, malnutrition, stigma, exploitation, sickness and often sexual abuse. The figures concerning those affected, which are staggering, offer various predictions regarding the number of orphans left in the wake of the pandemic. Between 1990 and 2003, the number of orphaned children rose from fewer than 1 million to more than 12 million in sub-Saharan Africa (UNICEF, 2005: 68). South Africa is severely affected by the AIDS pandemic, with the largest number of HIV infections in the world, a total of 5.7 million (RSA, 2010: 10), affecting approximately 3.2 million women and 280 000 children aged from 0 to14 years. There is a significant variation in HIV prevalence per province, with the Eastern Cape (EC) reportedly having an average prevalence rate of 28 percent. Hence South Africa is likely to be the country with highest percentage of children orphaned by AIDS within its population. Orphanhood is a major consequence of the AIDS pandemic in South Africa with an estimated 2.2 million AIDS-orphaned children, 11,188 per 100,000 by 2015. Most children who are AIDS orphans living in township communities live predominantly uncared for and unsupported. Therefore the purpose of this research study was to develop strategies to provide care and support to children who are AIDS orphans living in township communities. To achieve the purpose of this research study, a qualitative, exploratory, descriptive and contextual design was used by the researcher to gain insight from health and social care practitioners who render care and support to children who are AIDS orphans living in these communities. The data from in-depth interviews with the health and social care practitoners was used by the researcher to develop strategies to provide care and support to children who are AIDS orphans living in township communities. The study comprised the following four phases: Phase One: During this phase, the researcher will present an overview of the current legislative framework policies at an international, national and provincial level, regarding the the rights of children living in South Africa. Phase Two: During this phase data from two research populations were collected and analysed. As the research process of this study dealt with two groups of participants, namely in group one health care practitioners and group two comprised social workers and psychologists, who work in the township communities to provide care and support to children who are AIDS orphans living in these communities. The researcher discussed each group separately in the discussion of phase two of the study. Phase Three: Comprised the themes identified in the data gathered from the transcribed in-depth interviews, the field notes as well as the reflective journals were cross-validated to ensure trustworthiness of the data which was then organised into a conceptual framework. The conceptual framework was used to clarify the relationships of the concepts and the themes identified during the research process and also used to link the gathered data to previously established models and theories (Schneider, 2004: 133). Phase Four: The last phase of the research design, focused on the development of the “Steps of progression strategies” to provide holistic care and support to children who are AIDS orphans living in township communities. This was done making use of the themes identified during data analysis and the literature sources used throughout this research process. The evaluation criteria of Chinn and Kramer (2008: 237-248) were used to evaluate the strategies. It is therefore concluded that the researcher succeeded in achieving the purpose of this study because strategies which were understandable, clear, simple, applicable and significant to nursing practice have been developed for use by the Department of Health and Department of Social Development as well as primary health and social care practitioners to provide holistic care and support to children who are AIDS orphans living in township communities in South Africa.

HIV/AIDS has done a great damage to families and their children. Due to HIV/AIDS, grandmothers find themselves caring for their sick children, grandchildren and orphaned grandchildren. Because of the large number of AIDS orphans, the existing pool of community-based support has become saturated. Therefore these children now have to fend for themselves. They are forced to become heads of the households and breadwinners. In this situation the older children have to assume the role of looking after their siblings. Death caused by HIV/AIDS leaves children vulnerable, in great distress and poverty. The stigma and discrimination related to the HIV/AIDS pandemic has resulted in the isolation of infected persons and their family members. Sometimes the isolation continues until and even after the children become orphans. It is a fact that HIV/AIDS orphans as heads of households are undergoing traumatic experiences. On the psychological level children are traumatized by the illness of their parent(s). Because of the high rate of unemployed and pervasive poverty in this country many families are reluctant to take in orphans. Other problems are: the cost of treating illnesses caused by HIV/AIDS places a huge economic burden on families. After death, funeral expenses contribute to the toll exacted by HIV/AIDS. It becomes increasingly impossible for families and communities to absorb the cost and support the large numbers of children alone. Some women hesitate to take in the orphaned children of their relatives because they fear that their husbands will abuse the children Investigation into the existing literature reveals that previous studies concentrated mostly on the educational, psychosocial and emotional needs of people with HIV/AIDS. Studies on child headed households’ deals primarily with children’s rights and the accessibility of social grants for children infected and affected by HIV/AIDS. Although not much was available statistically, for the purpose of this study I have identified several households headed by children, whether the cause of this was HIV/AIDS or misfortunes such as parental suicide or accidents. This study has focused on the experiences of HIV/AIDS orphans in child headed households. This study has also investigated whether HIV/AIDS orphans suffer more deeply psychologically and emotionally than children who have been orphaned by other circumstances other than AIDS. This study highlights the many difficulties and setbacks experienced by HIV/AIDS orphans who become heads of households after the death of their parents. An exploratory research design was utilised and qualitative approach was followed. Five households were chosen as samples that complied with requirements of this study. Participants in these households were between ages 13 and 18 years old. The information gathered by means of literature and empirical research reveals that the children affected by HIV/AIDS are not only physically impoverished, but also psychologically, socially and spiritually. They suffer from fear, depression, stress, anxiety, stigmatisation and discrimination, isolation, and are often scorned by peers. HIV/AIDS orphans experience psychological trauma on account of witnessing their parent’s illness and death (or departure), carrying the responsibility of caring for sick parents, and after their death, for siblings. The socio-economic circumstances of HIV/AIDS orphans in child headed household often force them to drop out of school, in order to find ways of providing for the family. The traumatic experience of HIV/AIDS orphans and children who have been orphaned to other circumstances, are similar. The following themes can be considered for future research:<ul> <li>Stress experienced by HIV/AIDS orphans in child headed households due to HIV/AIDS</li>. <li>The role of churches in identifying and supporting orphans in child headed households</li>.</ul> / Dissertation (MTheol(Practical Theology))--University of Pretoria, 2006. / Practical Theology / unrestricted

HIV/AIDS epidemic has caused much devastation and has left many children destitute and in need of care and supervision. The present study investigated the psychological impact of caring on non-professional caregivers of HIV/AIDS orphans and children affected by HIV/AIDS. General systems theory stands as the epistemological framework informing the study. The study made use of a qualitative phenomenological approach to explore the lived experiences of eight non-professional caregivers who participated in the study .From the themes that were abstracted it was evident that caring for HIV/AIDS orphans is emotionally, physically and mentally strenuous for the caregivers. It was better recommended that caregivers be given recognition for their challenging work and be included in the planning and development of programmes that affect their caregiving role. Furthermore emotional, psycho-social, and income-generating skills support programmes including training and educational programmes should be implemented. This will alleviate the distress inherent to the caregiving role and to equip them with the necessary skills for handling the demands of their work. / Psychology / M.A. (Clinical Psychology)

South Africa is one of the countries most affected by HIV/AIDS, and the impact on children living in affected households and communit ies is significant. The loss of a parent or caregiver due to an AIDS. related illness has le ft many children orphaned. Understandings of bereavement. particularly amongst African adolescents. and adults’ responses to orphans’ psychological and emotional d ifficulties, remains under.developed. This paper explored adolescents’ experiences of par ental AIDS.related illness and bereavement. Ten adolescents participated in this s tudy. Qualitative methods such as observation, individual interviews and a focus grou p were the means of data collection. Key findings of the study were that: adolescents we re profoundly affected by the death of their parents with some showing signs of great anxi ety in relation to their future; were in need of emotional and material support; and were af fected by the intense stigma associated with HIV/AIDS which resulted in secrecy and shame. This study suggests that if we listen to the voices of children, we will learn about thei r emotional, psychological, developmental, and behavioural needs, which in turn will inform interventions working with vulnerable and orphaned children. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2009.

HIV/AIDS epidemic has caused much devastation and has left many children destitute and in need of care and supervision. The present study investigated the psychological impact of caring on non-professional caregivers of HIV/AIDS orphans and children affected by HIV/AIDS. General systems theory stands as the epistemological framework informing the study. The study made use of a qualitative phenomenological approach to explore the lived experiences of eight non-professional caregivers who participated in the study .From the themes that were abstracted it was evident that caring for HIV/AIDS orphans is emotionally, physically and mentally strenuous for the caregivers. It was better recommended that caregivers be given recognition for their challenging work and be included in the planning and development of programmes that affect their caregiving role. Furthermore emotional, psycho-social, and income-generating skills support programmes including training and educational programmes should be implemented. This will alleviate the distress inherent to the caregiving role and to equip them with the necessary skills for handling the demands of their work. / Psychology / M.A. (Clinical Psychology)

This study looked at how children who are exposed to the impact of HIV/AIDS in their immediate families are affected and what coping strategies they employ. Research was conducted in Lusaka, Zambia, involving eight female and eight male Zambian children between the ages of thirteen and sixteen, as research participants. Separate gender specific focus group discussions were held, after which the recorded proceedings were transcribed and analysed using thematic content analysis. The study found that children experience socioeconomic difficulties, psychosocial deprivations, and insecurity as a result of parental death or illness. However, they are still able to find ways to survive and cope with their difficulties. State and private sector efforts have focussed primarily on addressing the socioeconomic needs of these children as this has been understood to be the most critical. The psychological impact of HIV/AIDS on children in Zambia, and the resultant needs that arise, will need to be tackled as a matter of priority.

Thesis (M.A. (Clinical Psychology)) --University of Limpopo, 2008 / The aim of this study was to investigate the psychological difficulties encountered and ways of coping by HIV/AIDS orphans in Limpopo Province. The sample was comprised of 70 children whose parent(s) died of HIV/AIDS related diseases between the ages 05 and 18 years. The data were collected through the use of face to face interview and questionnaires. The study results show that as a results of trauma resulting from taking care and witnessing ill parent(s) die, HIV/AIDS orphans suffer from sadness, helplessness, anger, guilty, aggression and frustration that often lead to withdrawal and subsequent depression, In quantitative study Beck Depression Inventory was also used to determine the levels of depression (mild, moderate, and/or severe levels) and it was discovered that HIV/AIDS orphans experience moderate to severe depression. The study further looked on whether demographic factors including (age, gender, religion, home language, number of siblings, and level of education) have an impact on the experience of depression. Qualitative study findings also discovered that HIV/AIDS orphans do not experience the relationship with their caregivers as being supportive. Furthermore, mixing with non-orphaned peers was reported to be a mission and emotionally distressing. Qualitative study also discovered that HIV/AIDS orphans lack many adults whom they can trust and who they could be able to express their feelings, as result they try to find their own ways of coping with their circumstances. However, quantitative study also looked at three ways of coping (cognitive, behavioural and avoidance ways of coping) that could be used by HIV/AIDS orphans. This was achieved through the use of ways of coping scales. The findings of this study discovered that HIV/IADS orphans use cognitive and avoidance ways of coping more than behavioural ways of coping. Furthermore, the study looked at whether there is a relationship between ways of coping and biographic factors (age, gender, religion, home language, number of siblings, and level of education). It was discovered that HIV/AIDS orphans are psychologically distressed and need to be transferred for psychological therapy after the loss of their parents.

The goal of this study was to explore the experiences of children who were orphaned on account of HIV and AIDS as well as the experiences of their caregivers, thereby improving the knowledge base of practitioners working with children and their caregivers.This qualitative study was designed to answer the following research questions: • What are the experiences of children orphaned on account of HIV and AIDS? • What consequences does the HIV and AIDS pandemic have on children? • How do children cope with AIDS-related loss and grief? • What are the caregiver’s roles, experiences and perceptions regarding children orphaned on the account of HIV and AIDS? • What resources and support systems are available to caregivers in fulfilling their roles in relation to children? The social ecological model provided the theoretical framework for this study. Qualitative data was collected through personal interviews with eleven children and ten caregivers. This was supported by observational visits to the homes of the participants and secondary analysis of case files. The major themes that emerged were the phenomenon of absent fathers and the dominant role that women play. The caregivers had to keep their grief to themselves and more urgent stressors took priority in their lives. Grief was often held in abeyance as the caregivers had to focus on daily survival needs. Poverty overshadowed the lives of all the participants and a large portion of the South African population. Despite this the resilience on the part of the child participants was remarkable. Emanating from these themes, recommendations for social work practice and implications for future research are proposed. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.