Master of Public Health - MPH / Background: The repercussions of being HIV positive coupled by the complications of antiretroviral therapy are likely to cause distress, emotional and psychological problems particularly among children infected by the virus. The limited support services for children experiencing distress intensify the urgency to address this challenge. Despite the availability of social workers and nurses' interventions currently in place, the number of children in need of psychological care continues to increase. This is particularly true at Deborah Retief Memorial (DRM) hospital, one of the main antiretroviral therapy facilities in Kgatleng district, Botswana. Method: The purpose of this study was to explore and describe the perceptions of social workers, nurses and caregivers on key factors contributing to psychological distress of HIV positive children. A descriptive, exploratory qualitative study design that employed the use of in-depth interviews was used to conduct this study. Participants included four caregivers of HIV positive children who seek antiretroviral therapy at DRM hospital Infectious Diseases Control Clinic, together with five nurses and two social workers who worked in the same clinic. Conventional content analysis was used to analyse the in-depth interview transcripts. Results: Perceived psychological stressors for HIV positive children included disclosure of HIV status, orphanhood, social problems, lifelong treatment, stigma, poor caregiver-child relationship and lack of caregiver‟s love, care and support. However the caregivers did not fully understand the psychological distress the HIV positive children were experiencing, hence were unable to recognize it in these children. The study highlighted that major challenges faced by the health-workers included lack of qualified personnel, lack of adequate knowledge and skills, and a non-conducive working environment required to effectively assist children with psychological distress. The findings also indicated the need for education and support of caregivers and HIV positive children by the educators, family and health-worker systems. Conclusion: The profile of key stressors of psychological distress, the challenges and support needs suggested by the participants in this study can provide a framework for improving the existing services for HIV positive children with psychosocial problems. This information is important for use in training nurses and social workers involved with children with psychological behaviours.

Abstract in English, Sepedi and Zulu / The people with the greatest stake in Orphan and Vulnerable Children (OVC) interventions are the children and their parents/guardians. Unfortunately, most OVC programmes are predesigned and implemented without considering beneficiaries’ perceptions when developing solutions (ALI 2007:15). The purpose of this study was to explore and describe the perceptions of orphans and vulnerable children’s parents/guardians about the effectiveness of Future Families’ children programme in Olievenhoutbosch. This study used a qualitative, explorative and descriptive design. Thirteen parents/guardians of children registered with the Future Families were interviewed on the effectiveness of the Future Families programme using a semi-structure interview guide. The study results suggested that parents/guardians were happy with Future Families’ services and believed the programme is effective in responding to their families’ needs / Abantu abathinteka kakhulu ekungeneleni kokuphathelene nezintandane kanye nabantwana abasengcupheni (ama-OVC) ngabantwana kanye nabazali noma abaqaphi. Ngeshwa, izinhlelo eziningi zama-OVC zenziwe futhi ziqala ukusetshenziswa ngaphandle kokucabangela imibono yalabo okumele bahlomule kwizisombululo zokuthuthukisa (ALI 2007: 15). Inhloso yalolu cwaningo kwakuwukuhlola nokuchaza imibono yabazali nabaqaphi bama-OVC mayelana nokusebenza kohlelo lwabantwana olunikezwa yiFuture Families e-Olievenhoutbosch. Kwasetshenziswa uhlelo oluhlolayo noluchazayo kulolu cwaningo. Abazali abayishumi nesishiyagalolunye noma abaqaphi babantwana ababhalisiwe kwaFuture Families, okuyinhlangano engenzi nzuzo ehlinzeka izinsizakalo kuma-OVC nakubantu abaneHIV/AIDS noma abahlukumezekayo ngenxa yalokho, babuzwa imibuzo kusetshenziwa umhlahlandela wemibuzo ehlelekile kwezinye izindawo ukuze baveze imibono yabo maqondana nokusebenza ngempumelelo kohlelo lweFuture Families. Imiphumela yalolu cwaningo iphakamise ukuthi abazali nabaqaphi bagculisekile ngemisebenzi ehlinzekwa yiFuture Families, futhi bakholwa ukuthi lolu hlelo lusebenza ngempumelelo ukubhekana nezidingo zemindeni yabo. / Batho ba ba nago le setseka se segolo go ditseno ka bogare tša Bana ba Ditšhiwana le bao ba lego Kotsing (OVC) ke bana le batswadi/bahlokomedi ba bona. Ka bomadimabe, mananeo a mantši a OVC a akanyetšwa pele le go phethagatšwa ntle le go tšeela šedi maikutlo a batho ba ba tlago holega ge go naganišišwa ditharollo (ALI 2007:15). Morero wa thuto ye e be e le go hlohlomiša le go hlaloša maikutlo a ditšhiwana le batswadi/bahlokomedi ba bana ba ba lego kotsing mabapi le go šoma gabotse ga lenaneo la bana la Malapa a ka Moso (FF) kua Olievenhoutbosch. Thuto ye e šomišitše moakanyetšo wa khwalitheithifi, wa go hlohlomiša le wa go hlaloša. Batswadi/bahlokomedi ba 13 ba bana ba ba ingwadišitšego le Malapa a ka Moso ba ile ba botšišwa dipotšišo mabapi le go šoma gabotse ga lenaneo la Malapa a ka Moso ka go šomiša mokgwa wa dinyakišišo wa go botšiša dipotšišo. Dipoelo tša thuto di šišintše gore batswadi/bahlokomedi ba be ba thabile ka ditirelo tša FF le go dumela gore lenaneo le šoma gabotse ka go iphetolela go dinyakwa tša malapa a bona. / Health Studies / M.P.H.